Question

Explain the pathophysiology mechanism of irritable bowel syndrome and what are the treatments

How does stress effect pathophysiology and treatment

Answer 1

ANSWER

*Pathophysiology of irritable bowel syndrome.

           * Changes in the motility of intestine as a result of neuroendocrine

              dysregulation (changes in the seratonin action),infections,inflammatory

              disorders,sterss,metabolic and vascular disturbances etc.

          * This changes in intestinal motility adversely affect the peristaltic waves of

            specific segments of intestine.

          * Changes in the bowel movement affect the intensity with which the bowel propel

            the fecal matter forward for elimination.

          *All this changes in the bowel leads to function impairment of intestine and symptoms

           like alteration in bowel pattern,diarrhea,constipation ,abdominal cramps will occur.

* Treatment of irritable bowel syndrome.

           * Hydrophilic colloids(gelatin,pectin) and antidiarrheal agents(loperamide)

             used to control fecal urgency and diarrhea.

           * High fiber diet to maintain normal bowel movment and control diarrhea and

             constipation.

           * Antidepressants and sterss reduction therapy for patient who develop IBS

             due to stress and depression.

           * Anticholinergics and antispasmodics to smooth muscle spasm and abdominal

             cramping.

           * Probiotic therapy (eg;Bifidobacterium) to reduce abdominal bloating and gas.

Effect of stress on pathophysiology and treatment of IBS.

              * Stress causes changes in the central and pheripheral nerve system,intestinal

              sensitivity,gastrointestinal mucosal function and alteration in seratonin level which

                trigger development of irritable bowel syndrome.

              * During the treatment period anxiety or stress level of the patient negatively affect the

                recovery process so behaviour mordification programs and anti anxiety drugs are

                required for that type of patient.