Chronic Abdominal Pain. Dr. Robert B. Smith Tupelo Digestive Health Specialists August 26, 2016
|
|
|
- Collin Lindsey
- 6 years ago
- Views:
Transcription
1 Chronic Abdominal Pain Dr. Robert B. Smith Tupelo Digestive Health Specialists August 26, 2016
2 Disclosures Speaker Bureau for Allergan Pharmaceuticals
3 Abdominal Pain - Definitions Acute occurring for several days Chronic occurring intermittently or constantly for 3-6 months Subacute everything in between
4 Historical Features Location, Location, Location Radiation Character (Lancinating v Dull) Intensity probably less important more on this later! Timing in relation to meals Aggravating/alleviating factors (especially in relation to food, defecation, or menstruation) Associated features (vomiting, diarrhea, constipation) Alarm Features
5 Alarm Features Dysphagia Weight loss, new clothes Early satiety (?) Persistent nausea with vomiting Hematemesis, hematochezia, melena Family history of cancer or IBD Iron deficiency anemia (or sometimes B12 deficiency) Nocturnal symptoms or incontinence (especially for diarrhea) Age of onset greater than 50 years
6 Pain Sensitive Structures Skin Muscles/Fascia Serosa Viscera
7 Pain Mechanisms Inflammation Neuropathy Distension/Stretch Torsion Ischemia Functional
8 Abdominal Anatomy
9 Chronic Abdominal Pain Concept Map
10 Skin and Myofascial Pain
11 Visceral Pain Concept Maps
12 Visceral Pain Concept Maps
13 Visceral Pain Concept Maps
14 Exam Features Patient position (constantly changing v still) Inspection Scars, skin changes Palpation skin, deep palpation for organomegaly or masses Percussion with shifting Auscultation bruits Maneuvers Carnett sign
15 Evaluation Labs: CBC, CMP, Lipase (?), CRP, H pylori evaluation, TTG IgA, Total IgA Subsequent Labs: Calprotectin, B12, Ferritin, Iron Profile Endoscopy, CT, MRP: typically only for alarm features or other laboratory abnormalities
16 Diagnoses to Always Consider Malignancy Inflammatory Bowel Disease
17 Questions so far?
18 Functional Abdominal Pain Syndrome Rome III Criteria (all of the following) Continuous or almost continuous abdominal pain No or only occasional relationship of pain to physiologic events (defecation, eating, menses) Some loss of daily functioning Pain is not feigned Insufficient symptoms to meet criteria for another functional gastrointestinal disorder that would explain the pain *Criteria fulfilled for the past three months with symptom onset at least six months prior to diagnosis
19 Irritable Bowel Syndrome Rome III Criteria Recurrent abdominal pain or discomfort at least three days/month in the last three months associated with two or more of the following: Improvement with defecation Onset associated with a change in the frequency of stool Onset associated with a change in the form of stool Divided into diarrhea-predominant, constipation-predominant, and mixed
20 Neuroanatomic Pathways
21 Mediators of Functional Diseases Visceral hypersensitivity and cortical processing Intestinal microbiome Malabsorbed or maldigested nutrients Intracolonic bile acids Intestinal motility Mucosal permeability Relative concentrations of neurotransmitters (serotonin)
22 Biomedical model of Gastrointestinal Illness Illness can be linearly reduced to a single cause (reductionism) Therefore, identifying and modifying the underlying cause is necessary and sufficient to explain the illness and ultimately lead to cure. Illness can be dichotomized to a disease, or organic disorder, which has objectively defined pathophysiology, or a functional disorder, which has no specifically identifiable pathophysiology (dualism)
23 Biopsychosocial model of Gastrointestinal Illness
24 Influencers of disease severity in IBS
25 Treatment Principles for Functional Gastrointestinal Diseases Establishing therapeutic relationship with patients (biopsychosocial model) Establishing appropriate expectations Communicating the role of psychosocial factors, if present Reinforcing healthy behaviors (exercise, sleep, diet) Pharmacologic therapy Behavioral treatments (CBT) Avoiding furor medicus if possible
26 Pharmacotherapy for Functional Abdominal pain Tricyclic antidepressants primarily work by modulating descending pathways to mitigate pain; aid with depression at higher doses SSRIs less-extensively studied; help with comorbid psychiatric conditions SNRIs Drugs to avoid Opiates even if your patient tells you this is the only thing that works Benzos
27 Pharmacotherapy for IBS-C OTC Psyllium PEG (Miralax) Bisacodyl (Dulcolax) not approved, probably would avoid this one Docusate Linaclotide higher doses for IBS Lubiprostone chloride channel activator (approved at lower dose for IBS-C in women) Bile salt binders (Cholestyramine)
28 Pharmacotherapy for IBS-D OTC Loperamide (Mu-opioid agonist) Bismuch subsalicylate (anti-bacterial, anti-secretory, anti-inflammatory) Eluxadoline (Mixed-opioid receptor modulator) Diphenoxylate/atropine (Mu-opioid agonist and anticholinergic) Hyoscyamine and Dicyclomine (anticholinergic) Rifaximin (non-absorbable antibiotic)
29 Questions?
30 References Camilleri, Michael. "Peripheral mechanisms in irritable bowel syndrome."new England Journal of Medicine (2012): Feldman, Mark, Lawrence S. Friedman, and Lawrence J. Brandt, eds.sleisenger and Fordtran's gastrointestinal and liver disease: pathophysiology, diagnosis, management. Elsevier Health Sciences, Drossman, D. A. "The functional gastrointestinal disorders and the Rome II process." Gut 45.suppl 2 (1999): II1-II5. Drossman, Douglas A., et al. "Severity in irritable bowel syndrome: a Rome Foundation Working Team report." The American journal of gastroenterology (2011):
IBS and Functional GI Disorders (FGIDs)
Transcript Details This is a transcript of an educational program accessible on the ReachMD network. Details about the program and additional media formats for the program are accessible by visiting: https://reachmd.com/programs/gi-insights/ibs-and-functional-gi-disorders-fgids/7424/
IBS Irritable Bowel syndrome Therapeutics II PHCL 430
Salman Bin AbdulAziz University College Of Pharmacy IBS Irritable Bowel syndrome Therapeutics II PHCL 430 Email:- ahmedadel.pharmd@gmail.com Ahmed A AlAmer PharmD R.S is 32-year-old woman experiences intermittent
Disorders in which symptoms cannot be explained by the presence of structural or tissue abnormalities Irritable bowel syndrome Functional heartburn Functional dyspepsia Functional constipation Functional
IBS - Definition. Chronic functional disorder of GI generally characterized by:
IBS - Definition Chronic functional disorder of GI generally characterized by: 3500 3000 No. of Publications 2500 2000 1500 1000 Irritable Bowel syndrome Irritable Bowel Syndrome 500 0 1968-1977 1978-1987
Irritable Bowel Syndrome Now. George M. Logan, MD Friday, May 5, :35 4:05 PM
Irritable Bowel Syndrome Now George M. Logan, MD Friday, May 5, 2017 3:35 4:05 PM Dr. Logan indicated no potential conflict of interest to this presentation. He does not intend to discuss any unapproved/investigative
The Use of Antidepressants in the Treatment of Irritable Bowel Syndrome and Other Functional GI Disorders What are functional GI disorders?
The Use of Antidepressants in the Treatment of Irritable Bowel Syndrome and Other Functional GI Disorders Christine B. Dalton, PA-C Douglas A. Drossman, MD and Kellie Bunn, PA-C What are functional GI
Presenter. Irritable Bowel Syndrome. Objectives. Introduction. Rome Criteria. Irritable Bowel Syndrome 2/28/2018
Presenter Irritable Bowel Syndrome Current evidence for diagnosis & management Julie Daniels DNP, CNM Assistant Professor Course Coordinator of Primary Care of Women Faculty at Frontier Nursing University
Is one of the most common chronic disorders. causing patients to seek medical treatment.
ILOs After this lecture you should be able to : Define IBS Identify causes and risk factors of IBS Determine the appropriate therapeutic options for IBS Is one of the most common chronic disorders causing
Primary Management of Irritable Bowel Syndrome
Primary Management of Irritable Bowel Syndrome Jasmine Zia, MD Acting Instructor, Division of Gastroenterology Current Concepts in Drug Therapy CME Course April 23, 2015 Irritable Bowel Syndrome (IBS)
Irritable Bowel Syndrome. Mustafa Giaffer March 2017
Irritable Bowel Syndrome Mustafa Giaffer March 2017 Introduction First described in 1771. 50% of patients present
Why does my stomach hurt? Exploring irritable bowel syndrome
Why does my stomach hurt? Exploring irritable bowel syndrome By Flavio M. Habal, MD, PhD, FRCPC Case In this article: 1. What is IBS? A 45-year-old female is referred to your office with recurrent 2. How
MANAGEMENT OF VISCERAL PAIN
MANAGEMENT OF VISCERAL PAIN William D. Chey, MD, FACG Professor of Medicine University of Michigan 52 year old female with abdominal pain 5 year history of persistent right sided burning/sharp abdominal
Objectives. Pain Types Brief Review. Referred Pain. Chronic/Recurrent Abdominal Pain 1/12/2017. I have no conflicts of interest to disclose
Joshua D Noe, MD Associate Professor of Pediatric Gastroenterology Hepatology and Nutrition Medical College of Wisconsin I have no conflicts of interest to disclose Objectives Differentiate functional
Xifaxan, Lotronex and Viberzi Prior Authorization and Quantity Limit Program Summary
Xifaxan, Lotronex and Viberzi Prior Authorization and Quantity Limit Program Summary FDA APPROVED INDICATIONS DOSAGE 1,2 Lotronex (alosetron) a Indication For women with severe diarrheapredominant irritable
CHAPTER 11 Functional Gastrointestinal Disorders (FGID) Mr. Ashok Kumar Dept of Pharmacy Practice SRM College of Pharmacy SRM University
CHAPTER 11 Functional Gastrointestinal Disorders (FGID) Mr. Ashok Kumar Dept of Pharmacy Practice SRM College of Pharmacy SRM University 1 Definition of FGID Chronic and recurrent symptoms of the gastrointestinal
Evolving Therapy in Irritable Bowel Syndrome (IBS)
Evolving Therapy in Irritable Bowel Syndrome (IBS) Dr. Syed Mohammad Arif MBBS, FCPS (Medicine), MD (Gastro) Associate Professor Department of Medicine Dhaka Medical College A good set of bowels is worth
David Leff, DO. April 13, Disclosure. I have the following financial relationships to disclosure:
David Leff, DO AOMA 94 th Annual Convention April 13, 2016 Disclosure I have the following financial relationships to disclosure: Speaker s Bureau: Allergan Labs, Takeda Pharmaceutical, Valeant Pharmaceutical
Bloating, Flatulence, and
A 45-Year-Old Man With Recurrent Abdominal Pain, Bloating, Flatulence, and Intermittent Loose Stools Anthony J. Lembo, MD Associate Professor of Medicine Harvard Medical School Director, GI Motility Laboratory
IBS-D: The Role of Pathophysiology in Assessment and Treatment ReachMD Page 1 of 7
Transcript Details This is a transcript of a continuing medical education (CME) activity accessible on the ReachMD network. Additional media formats for the activity and full activity details (including
Irritable Bowel Syndrome. Paul Sheykhzadeh, DO, FACG Digestive Health Associates Reno, NV NAPNA Symposium March 5, 2016
Irritable Bowel Syndrome Paul Sheykhzadeh, DO, FACG Digestive Health Associates Reno, NV NAPNA Symposium March 5, 2016 Definition of Irritable Bowel Syndrome (IBS) Rome III Criteria Recurrent abdominal
Pharmacotherapy for IBS
Pharmacotherapy for IBS Brooks D. Cash, M.D., FACG Chief, Gastroenterology Professor of Medicine University of South Alabama Director, GI Physiology, USA Medical Center Mobile, AL Disclosures I have served
IBS. Dan Carter, M.D. Institute of Gastroenterology Sheba medical center
IBS Dan Carter, M.D. Institute of Gastroenterology Sheba medical center Epidemiology Irritable bowel syndrome is a common functional gastrointestinal disorder that manifests as abdominal pain or discomfort
4) Irritable Bowel Syndrome - Dr. Shaikhani. Epidemiology. Pathophysiology. Burden. Diagnosis
4) Irritable Bowel Syndrome - Dr. Shaikhani Epidemiology A common disorder, with a 7% prevalence. Women are 1.5 times more likely to be affected than men, most commonly between ages 20-40 years. Onset
IBS CLOSED REFERRAL STATUS: Dear Dr.,
Name: PHN/ULI: DOB: RHRN: RefMD: Dr. RefMD Fax: RefDate: Date Today: CONFIRMATION: TRIAGE CATEGORY: REFERRAL STATUS: Dear Dr., Referral Received Enhanced Primary Care Pathway CLOSED IBS The clinical and
What is Irritable Bowel Syndrome (IBS)?
What is Irritable Bowel Syndrome (IBS)? Irritable bowel syndrome (IBS) is a health issue found in your intestines (gut). IBS can cause symptoms such as: Belly pain. Cramping. Gas. Bloating (or swelling)
Irritable Bowel Syndrome
68 TH ANNUAL MCGILL REFRESHER COURSE FOR FAMILY PHYSICIANS 2017 Irritable Bowel Syndrome Gad Friedman, MDCM, FRCPC Jewish General Hospital DISCLOSURES I have no disclosures LEARNING OBJECTIVES 1. Review
Irritable Bowel Syndrome
Irritable Bowel Syndrome Functional gastrointestinal disorders Definition A variable combination of chronic or recurrent gastrointestinal symptoms (attributed to the pharynx, esophagus, stomach, biliary
... SELECTED ABSTRACTS...
... SELECTED ABSTRACTS... The following abstracts, from medical journals containing literature on irritable bowel syndrome, were selected for their relevance to this supplement. A Technical Review for
Drossman Gastroenterology 55 Vilcom Center Drive Boyd Hall, Suite 110 Chapel Hill, NC 27514
Drossman Gastroenterology 55 Vilcom Center Drive Boyd Hall, Suite 110 Chapel Hill, NC 27514 History of Functional Disorders Douglas A. Drossman, MD Melissa Swantkowski THE PAST HISTORICAL PRECEDENTS Historians
Diagnosis and Management of Irritable Bowel Syndrome (IBS) For the Primary Care Provider
Diagnosis and Management of Irritable Bowel Syndrome (IBS) For the Primary Care Provider Elizabeth Coss, MD General Gastroenterologist Audie Murphy Veterans Hospital UT Health This presentation does not
An Approach to Abdominal Pain
An Approach to Abdominal Pain objectives Should know the different types of abd pain Is acute or chronic? Hx taking skills with knowing the key questions Important abdominal pain signs A good differential
GASTROENTEROLOGY ESSENTIALS
GASTROENTEROLOGY ESSENTIALS Practical Gastroenterology 8/25/2018 Jahnavi Koppala, MBBS Abdullah Abdussalam, MD A 48-year-old male was evaluated for noncardiac chest pain. Treatment with PPI twice daily
IBS-D: What to Do When Typical Treatment Methods Fail
Transcript Details This is a transcript of a continuing medical education (CME) activity accessible on the ReachMD network. Additional media formats for the activity and full activity details (including
ROME IV CRITERIA FOR IBS
PRACTICAL CONSIDERATIONS IN THE MANAGEMENT OF IBS BRENDA HORWITZ MD PROFESSOR OF CLINICAL MEDICINE LEWIS KATZ SCHOOL OF MEDICINE AND TEMPLE UNIVERSITY HEALTH SCIENCES CENTER OR THINGS I ALWAYS WANTED TO
Advancing gastroenterology, improving patient care
American College of Gastroenterology Advancing gastroenterology, improving patient care Note to Visitors: A fully updated ACG Systematic Review on the Management of Chronic Idiopathic Constipation and
Tenapanor for irritable bowel syndrome with constipation
NIHR Innovation Observatory Evidence Briefing: February 2018 Tenapanor for irritable bowel syndrome with constipation NIHRIO (HSRIC) ID: 6704 NICE ID: 9736 LAY SUMMARY Irritable bowel syndrome with constipation
Chronic diarrhea. Dr.Nasser E.Daryani Professor of Tehran Medical University
1 Chronic diarrhea Dr.Nasser E.Daryani Professor of Tehran Medical University Timing Acute diarrhea: 4 weeks Definitions Derived from Greek
10/1/2016. Kimberly Kearns, MS, APN, ANP-BC Mary Davitt, MS, PMHNP-BC Rachel Richardson, RD. Kimberly Kearns, APN. Mary Davitt, PMHNP.
Kimberly Kearns, MS, APN, ANP-BC Mary Davitt, MS, PMHNP-BC Rachel Richardson, RD Kimberly Kearns, APN Speakers Bureau: Medtronic Salix Pharmaceuticals Takeda Pharmaceuticals Mary Davitt, PMHNP None Rachel
Understanding and Managing IBS and CIC in the Primary Care Setting
May 2018 Volume 14, Issue 5, Supplement 3 Understanding and Managing IBS and CIC in the Primary Care Setting Brooks D. Cash, MD Chief of the Division of Gastroenterology, Hepatology, and Nutrition University
Efficacy and Safety of Lubiprostone. Laura Wozniak February 23, 2010 K30 Monthly Journal Club
Efficacy and Safety of Lubiprostone Laura Wozniak February 23, 2010 K30 Monthly Journal Club Objectives Brief overview of constipation Review of article Discussion Constipation in Children 3-5% of all
FUNCTIONAL DISORDERS TREATMENT ADVANCES. Dr. Adriana Lazarescu MD FRCPC Director GI Motility Lab, Edmonton Associate Professor University of Alberta
FUNCTIONAL DISORDERS TREATMENT ADVANCES Dr. Adriana Lazarescu MD FRCPC Director GI Motility Lab, Edmonton Associate Professor University of Alberta Name: Dr. Adriana Lazarescu Conflict of Interest Disclosure
PELVIC PAIN : Gastroenterological Conditions
PELVIC PAIN : Gastroenterological Conditions Departman Tarih Prof. A. Melih OZEL, MD Department of Gastroenterology Anadolu Medical Center Hospital Gebze Kocaeli - TURKEY Presentation plan 15 min. Introduction
Microbiome GI Disorders
Microbiome GI Disorders Prof. Ram Dickman Neurogastroenterology Unit Rabin Medical Center Israel 1 Key Points Our gut microbiota Were to find them? Symbiosis or Why do we need them? Dysbiosis or when things
Clinically proven to quickly relieve symptoms of common gastrointestinal disorders. TERRAGASTRO - Good health starts in the gut
Clinically proven to quickly relieve symptoms of common gastrointestinal disorders GASTROINTESTINAL DISEASE Referred to as gastrointestinal diseases, they are common disorders which affect the esophagus,
IBS: overview and assessment of pain outcomes and implications for inclusion criteria
IBS: overview and assessment of pain outcomes and implications for inclusion criteria William D. Chey, MD Professor of Medicine University of Michigan What is the Irritable Bowel Syndrome Symptom based
Outline. Definition (s) Epidemiology Pathophysiology Management With an emphasis on recent developments
Chronic Dyspepsia Eamonn M M Quigley MD FRCP FACP MACG FRCPI Lynda K and David M Underwood Center for Digestive Disorders Houston Methodist Hospital Houston, Texas Outline Definition (s) Epidemiology Pathophysiology
Disclosures. Objectives. Pre-Test Question 1. Pre-Test Question 2. Pre-Test Question 3 9/23/2016
Disclosures Beating the Bowel Blues: An Update on the Treatment of Irritable Bowel Syndrome Matthew Nelson, PharmDBCPS, Roosevelt University College of Pharmacy Matthew Nelson declares no conflicts of
SUPPLEMENTARY INFORMATION Associated with
Table1: Rome III and Rome IV diagnostic criteria for IBS, functional constipation and functional dyspepsia. Rome III diagnostic criteria 1,2 Rome IV diagnostic criteria 3,4 Diagnostic criteria for IBS
UKLIN1693a, date of preparation: March 2013.
1 This table shows the ICE model. Defining the patient s ideas, concerns, and expectations is an important part of the consultation that can lead to better outcomes. 2 Patients with IBS may have visceral
Irritable Bowel Syndrome and Chronic Constipation. Treatment of IBS. Susan Lucak, M.D. Columbia University Medical Center
Ti tl e s l i d e - p a rt 1 Irritable Bowel Syndrome and Chronic Constipation Susan Lucak, M.D. Columbia University Medical Center Treatment of IBS Abdominal pain / discomfort Antispasmodics Antidepressants
IRRITABLE BOWEL SYNDROME
DR. PHILIP K. BLUSTEIN M.D. F.R.C.P.(C) 415 14 TH ST. NW. CALGARY AB T2N2A1 PHONE (403) 270-9555 FAX (403) 270-7479 IRRITABLE BOWEL SYNDROME DEFINITION: *FUNCTIONAL GASTROINTESTINAL DISORDER CHARACTERIZED
June By: Reza Gholami
ACG/CAG guideline on Management of Dyspepsia June 2017 By: Reza Gholami DEFINITION OF DYSPEPSIA AND SCOPE OF THE GUIDELINE Dyspepsia was originally defined as any symptoms referable to the upper gastrointestinal
PELVIC PAIN : Gastroenterological Conditions
PELVIC PAIN : Gastroenterological Conditions Departman Tarih Prof. A. Melih OZEL, MD Department of Gastroenterology Anadolu Medical Center Hospital Gebze Kocaeli - TURKEY Presentation plan 15 min. Introduction
Chronic Abdominal Pain in Children
PedsCases Podcast Scripts This is a text version of a podcast from Pedscases.com on Chronic Abdominal Pain in Children. These podcasts are designed to give medical students an overview of key topics in
Irritable Bowel Syndrome and Chronic Constipation
Title slide - part 1 Irritable Bowel Syndrome and Chronic Constipation IBS - Physiologic Research Stress affects GI function Meals Pain / motility Time Line of Physiologic Research in IBS Pain sensitivit
Statement of Sponsorship and Support
Case Studies in the Practical Evaluation and Management of Irritable Bowel Syndrome with Diarrhea Louis Kuritzky MD Clinical Assistant Professor Emeritus Department of Community Health and Family Medicine
Current Pharmacological Treatment Options in Chronic Constipation and IBS with Constipation
Current Pharmacological Treatment Options in Chronic Constipation and IBS with Constipation Anthony Lembo, M.D. Associate Professor of Medicine Harvard Medical School Director, GI Motility Center Beth
Do Probiotics Provide Adequate Relief From Overall Symptoms, Including Abdominal Pain and Bloating, in Adults With Irritable Bowel Syndrome?
Philadelphia College of Osteopathic Medicine DigitalCommons@PCOM PCOM Physician Assistant Studies Student Scholarship Student Dissertations, Theses and Papers 2015 Do Probiotics Provide Adequate Relief
10/10/16. Disclosures. Educational Objectives
Nimish Vakil, MD, FACP, FACG, AGAF, FASGE Clinical Adjunct Professor University of Wisconsin Madison, Wisconsin Disclosures All faculty, course directors, planning committee, content reviewers and others
IBS. Patient INFO. A Guide to Irritable Bowel Syndrome
Patient INFO IBS A Guide to Irritable Bowel Syndrome The information provided by the AGA Institute is not medical advice and should not be considered a replacement for seeing a medical professional. About
Digestion. Text. What You Don t Know Can Hurt You!
Digestion Text What You Don t Know Can Hurt You! Digestive Problems Approximately 36.5 million visits annually to ambulatory care facilities due to the diseases of the digestive system Over 4 million ulcers
Irritable Bowel Syndrome: Current and Emerging Treatment Options
Irritable Bowel Syndrome: Current and Emerging Treatment Options Lauren Peyton, PharmD, CDE; and Joy Greene, PharmD INTRODUCTION Irritable bowel syndrome (IBS), one of the most prevalent functional gastrointestinal
Irritable Bowel Syndrome vs Inflammatory Bowel Disease
Irritable Bowel Syndrome vs Inflammatory Bowel Disease Lana Bistritz MD FRCPC Royal Alexandra Hospital Faculty/Presenter Disclosure Faculty: Lana Bistritz Relationships with financial sponsors: Grants/Research
Current and Emerging Pharmacological Treatments in Irritable Bowel Syndrome
Current and Emerging Pharmacological Treatments in Irritable Bowel Syndrome Anthony Lembo, M.D. Associate Professor of Medicine Beth Israel Deaconess Medical Center Harvard Medical School What is the general
Irritable bowel syndrome diagnosis and management: A simplified algorithm for clinical practice
Review Article Irritable bowel syndrome diagnosis and management: A simplified algorithm for clinical practice United European Gastroenterology Journal 2017, Vol. 5(6) 773 788! Author(s) 2016 Reprints
What s New in IBS with Diarrhea. Dr. Geoffrey K. Turnbull, MD April 6, 2018.
What s New in IBS with Diarrhea Dr. Geoffrey K. Turnbull, MD April 6, 2018. Objectives To learn how to diagnose IBS with particular emphasis on patients who have diarrhea predominantly. Review management
Bowel cancer risk in the under 50s. Greg Rubin Professor of General Practice and Primary Care
Bowel cancer risk in the under 50s Greg Rubin Professor of General Practice and Primary Care Prevalence of GI problems in the consulting population Thompson et al, Gut 2000 Number of patients % of patients
ACUTE ABDOMEN. Dr. M Asadi. Surgical Oncology Research Center MUMS. Assistant Professor of General Surgery
ACUTE ABDOMEN Dr. M Asadi Assistant Professor of General Surgery Surgical Oncology Research Center MUMS Definition I. The term Acute Abdomen refers to signs & symptoms of abdominal pain and tenderness,
Management of Functional Bowel Disorders
Management of Functional Bowel Disorders Amy Foxx-Orenstein, DO, FACG, FACP Professor of Medicine Mayo Clinic Tucson Osteopathic Medical Foundation May 1, 2016 Objectives Review epidemiology and pathophysiology
Constipation an Old Friend. Presented by Dr. Keith Harris
Constipation an Old Friend Presented by Dr. Keith Harris Irregularity and the Tricks of the Trade." CONSTIPATION What is constipation? INFREQUENT BOWEL MOVEMENTS DIFFICULTY DURING DEFECATION SENSATION
Psycho-pharmacologic Therapy. Objectives
Psycho-pharmacologic Therapy for Functional Bowel Disorders John J. Hutchings, M.D. Assistant Professor of Medicine and Psychiatry Louisiana i State t University it School of Medicine i Department of Medicine
GI Pharmacology -4 Irritable Bowel Syndrome and Antiemetics. Dr. Alia Shatanawi
GI Pharmacology -4 Irritable Bowel Syndrome and Antiemetics Dr. Alia Shatanawi 11-04-2018 Drugs used in Irritable Bowel Syndrome Idiopathic, chronic, relapsing disorder characterized by abdominal discomfort
OCTOBER 7-10 PHILADELPHIA, PENNSYLVANIA
OMED 17 OCTOBER 7-10 PHILADELPHIA, PENNSYLVANIA 29.5 Category 1-A CME credits anticipated ACOFP / AOA s 122 nd Annual Osteopathic Medical Conference & Exposition Joint Session with ACOFP and Cleveland
Technology appraisal guidance Published: 30 August 2017 nice.org.uk/guidance/ta471
Eluxadoline for treating irritable bowel syndrome with diarrhoea Technology appraisal guidance Published: 30 August 2017 nice.org.uk/guidance/ta471 NICE 2017. All rights reserved. Subject to Notice of
Objectives. Identify age-related changes in the gastrointestinal tract
The Primary Care Physician s Approach to Gastrointestinal Complaints in the Elderly Brian Viviano, D.O. Medical Associates of Erie Objectives Identify age-related changes in the gastrointestinal tract
ABDOMINAL PAIN THE GREAT CLINIC FRONTIER
THE GREAT CLINIC FRONTIER 2017 MONA ADVANCED PRACTICE NURSING CONFERENCE Matthew Bechtold MD, FACP, FASGE, FACG, AGAF Associate Professor of Medicine Division of Gastroenterology University of Missouri
Ever wonder what s really happening on the inside?
For Practitioners Ever wonder what s really happening on the inside? Are your patients suffering from diarrhea, constipation, bloating, gas or indigestion? Rocky Mountain Analytical is now offering Gut-Well
Probiotics in IBS. Dr. Partha Pratim Das Associate Professor Dhaka Medical college
Probiotics in IBS Dr. Partha Pratim Das Associate Professor Dhaka Medical college Definitions Probiotics: Live microorganisms that confer a health benefit on the host when administered in adequate amounts.
Lower Gastrointestinal Tract KNH 406
Lower Gastrointestinal Tract KNH 406 Lower GI Tract A&P Small Intestine Anatomy Duodenum, jejunum, ileum Maximum surface area for digestion and absorption Specialized enterocytes from stem cells of crypts
Lead team presentation Eluxadoline for treating irritable bowel syndrome with diarrhoea (STA)
Public slides Lead team presentation Eluxadoline for treating irritable bowel syndrome with diarrhoea (STA) 1 st Appraisal Committee meeting Committee B, 25th January 2017 Lead team: Nigel Westwood, Anne
The effect of fluoxetine in patients with pain and constipation-predominant irritable bowel syndrome: a double-blind randomized-controlled study
Aliment Pharmacol Ther 2005; 22: 381 385. doi: 10.1111/j.1365-2036.2005.02566.x The effect of fluoxetine in patients with pain and constipation-predominant irritable bowel syndrome: a double-blind randomized-controlled
5 Things to Know About Irritable Bowel Syndrome
5 Things to Know About Irritable Bowel Syndrome Mike Kolber MD, CCFP, MSc PEIP 2017 Faculty/Presenter Disclosure Presenter: Mike Kolber Relationships that may introduce potential bias and/or conflict of
Constipation An Overview. Definition Physiology of GI tract Etiology Assessment Treatment
CONSTIPATION Constipation An Overview Definition Physiology of GI tract Etiology Assessment Treatment Definition Constipation = the infrequent passage of hard feces Definition of Infrequent The meaning
Pediatric Gastroenterology Referral Guidelines
Suggested Pre-Referral Workup This is a general suggestion of possible testing to confirm a suspected diagnosis. Although referrals will be accepted without the suggested work up being complete, to ensure
8/29/2016 DIVERTICULAR DISEASE: WHAT EVERY NURSE PRACTITIONER SHOULD KNOW. LENORE LAMANNA Ed.D, ANP-C LEARNING OBJECTIVES
DIVERTICULAR DISEASE: WHAT EVERY NURSE PRACTITIONER SHOULD KNOW LENORE LAMANNA Ed.D, ANP-C LEARNING OBJECTIVES Define Diverticular Disease Discuss Epidemiology and Pathophysiology of Diverticular disease
Irritable Bowel Syndrome (IBS)
Irritable Bowel Syndrome (IBS) Dr Rex J Polson 17 th January 2018 Overview Description of the condition Discussion of symptoms and investigations that may be required Discussion of management and treatment
Integrating Novel Diagnostic Strategies into Practice: Key Points. Stanley Cohen, MD Emory University Atlanta, Georgia
Integrating Novel Diagnostic Strategies into Practice: Key Points Stanley Cohen, MD Emory University Atlanta, Georgia Disclosure Research: Janssen, Covidien/Medtronics, AbbVie, AstraZeneca and QOL Speaker:
Chapter 32 Gastroenterology General Pathophysiology General Risk Factors for GI emergencies: Excessive Consumption Excessive Smoking Increased
1 2 3 4 5 6 7 Chapter 32 Gastroenterology General Pathophysiology General Risk Factors for GI emergencies: Excessive Consumption Excessive Smoking Increased Ingestion of Caustic Substances Poor Bowel Habits
190 Index Case studies, abdominal pain, 2 Crohn s disease, 2 3, cyclic vomiting syndrome (CVS), 2 fecal incontinence (FI), 2 medical c
Index Abdominal pain, case study, 2 Achalasia, 75 Acupuncture 108 American Academy of Pediatrics, 49 Anxiety, 8 9, 98 Autism, GI disorders and, 25 27 BASC. See Behavior Assessment System for Children (BASC)
What s New & Common Presentations in Upper GI. Dr Philip Woodland Consultant Gastroenterologist Royal London Hospital
What s New & Common Presentations in Upper GI Dr Philip Woodland Consultant Gastroenterologist Royal London Hospital Reflux Dysphagia Dyspepsia (inc H.pylori) Vomiting The patient with reflux symptoms
Antidiarrheals Antidiarrheal
Antidiarrheals Major factors in diarrhea Increased motility of the GI tract. Decreased absorption of fluid. Antidiarrheal drugs include: Antimotility agents. Adsorbents. Drugs that modify fluid and electrolyte
Guidelines NICE, not NICE and the Daily Mail. Dr Andy Poullis Consultant Gastroenterologist
Guidelines NICE, not NICE and the Daily Mail 2018 Dr Andy Poullis Consultant Gastroenterologist Coeliac IBS Gall bladder polyps PEI PPI Who to test for Coeliac persistent unexplained abdominal or gastrointestinal
NEL RISPETTO DELLE NUOVE DISPOSIZIONI IN MATERIA DI ECM, A SEGUITO DELL ATTUAZIONE DELL ACCORDO STATO-REGIONI DEL 5/11/09 E SUCCESSIVE
NOME E NUMERO DEL PROVIDER: I&C SRL - 5387 ECM N : 180726 TITOLO: XVII CONGRESSO NAZIONALE GISMAD SEDE: MILANO, HOTEL NHOW DATA: 09-10/03/2017 NEL RISPETTO DELLE NUOVE DISPOSIZIONI IN MATERIA DI ECM, A
Gastroenterology. Certification Examination Blueprint. Purpose of the exam
Gastroenterology Certification Examination Blueprint Purpose of the exam The exam is designed to evaluate the knowledge, diagnostic reasoning, and clinical judgment skills expected of the certified gastroenterologist
Diagnosis and Treatment of Irritable Bowel Syndrome
Special Issue Diagnosis and Treatment of Irritable Bowel Syndrome Myung Gyu Choi, M.D. Department of Internal Medicine The Catholic University of Korea, College of Medicine Kangnam St. Mary's Hospital
Functional Dyspepsia
Functional Dyspepsia American College of Gastroenterology Boston Massachusetts, June 2015 Brian E. Lacy, PhD, MD, FACG Professor of Medicine Geisel School of Medicine at Dartmouth Chief, Section of Gastroenterology
CHRONIC DIARRHEA DR. PHILIP K. BLUSTEIN M.D. F.R.C.P.(C) DEFINITION: *LOOSE, WATERY STOOLS *MORE THAN 3 TIMES A DAY *FOR MORE THAN 4 WEEKS
DR. PHILIP K. BLUSTEIN M.D. F.R.C.P.(C) 415 14 TH ST. NW. CALGARY AB T2N2A1 PHONE (403) 270-9555 FAX (403) 270-7479 CHRONIC DIARRHEA DEFINITION: *LOOSE, WATERY STOOLS *MORE THAN 3 TIMES A DAY *FOR MORE
Western Health Specialist Clinics Access & Referral Guidelines
Gastroenterology Specialist Clinics at Western Health: Western Health provides the following Specialist Clinics for patients who require assessment and management of Gastroenterology / Hepatology conditions.
GASTROENTEROLOGY Maintenance of Certification (MOC) Examination Blueprint
GASTROENTEROLOGY Maintenance of Certification (MOC) Examination Blueprint ABIM invites diplomates to help develop the Gastroenterology MOC exam blueprint Based on feedback from physicians that MOC assessments
Spectrum of Diverticular Disease. Outline
Spectrum of Disease ACG Postgraduate Course January 24, 2015 Lisa Strate, MD, MPH Associate Professor of Medicine University of Washington, Seattle, WA Outline Traditional theories and updated perspectives