207 – Is the Association of IBS with Fibromyalgia and Other Non-Gastrointestinal Functional Disorders Important and Why?
Patients usually go to doctors with symptoms, not with the names of diseases or conditions. The doctor’s task is to make sense of the patient’s complaints within the framework of medical diagnoses and recognized diseases. But many patients have symptoms that remain unexplained after the diagnostic process is exhausted. This is the case because modern medicine focuses on diseases that have a basis in the structure or anatomy of the body systems rather than functional disorders that have a basis in how the systems work. In effect, symptoms remain “unexplained” not because they cannot be explained but because some doctors do not know how to explain them. Revised and updated 2009.
209 – Gut Bacteria and Irritable Bowel Syndrome
Does bacteria play a role in IBS? If so, is it helpful or harmful? What about antibiotics, or probiotics? Bacteria are present in the normal gut (intestines) and in large numbers the lower parts of the intestine. These “normal” bacteria have important functions in life. A variety of factors may disturb the mutually beneficial relationship between the gut bacteria and its host – and disease may result. The possibility that gut bacteria could have a role in irritable bowel syndrome (IBS) may surprise some; there is indeed, now quite substantial evidence to support the idea that disturbances in the bacteria that populate the intestine may have a role in at least some patients with IBS. This article looks at recent findings about possible influences of bacteria in IBS, which may be either negative or positive, and at various treatment approaches.
247- Changes You Should Not Ignore if You Have IBS
An “alarm” symptom, sometimes also called a “red flag,” simply means a symptom not explained by IBS, which calls for additional investigation. Dr. Thompson discusses the development of alarm symptoms and how to know when to see your doctor about them.
255 – What is IBS?
IBS is the most common of the functional disorders of the digestive tract. It is characterized by chronic abdominal pain and irregular bowel movements. #255
515 – Functional Dyspepsia and IBS: Incidence and Characteristics
Symptom overlap is common among several functional GI disorders. For instance, care must be taken not to confuse functional dyspepsia with other common disorders that may cause upper gastrointestinal distress, like heartburn, IBS, gastroesophageal reflux disease (GERD), functional abdominal bloating, and functional biliary disorders. This article compares two common functional GI disorders – functional dyspepsia and IBS.
226 – Irritable Bowel Syndrome (IBS), Heartburn, Dyspepsia: What’s the Difference?
The anatomical diseases Crohn’s, peptic ulcer, and esophagitis have functional counterparts with some similar symptoms; irritable bowel syndrome (IBS), dyspepsia, and functional heartburn, but these cannot be identified by x-ray or gastroscopy. Thus, for the diagnosis of these functional disorders doctors must rely entirely upon the patient’s description of his or her symptoms.
234- A Noisy Tummy: What Does it Mean?
While seldom of medical importance, for some people a rumbling, growling stomach can be a source of profound embarrassment. Picturesquely dubbed “borborygmi,” bowel sounds seem loudest to the owner, who is sometimes mistakenly convinced they are obvious to all. This article explains the causes of bowel sounds, discusses when the sounds become a cause for medical concern, and offers some tips that may help reduce bowel noises.
262-Understanding Bloating and Distension
Bloating can be described as the feeling that there is an inflated balloon in the abdomen. It is a commonly reported symptom and is sometimes associated with distension, or the visible increase in the width of the area between your hips and chest (abdominal girth). Both bloating and distension cause discomfort, and sometimes pain, and have a negative impact on the quality of life for some individuals.
524 – Confusing or Ambiguous Upper Gut Symptoms
By choosing the appropriate test, a doctor can make a precise diagnosis of a structural upper gut disorder, such as esophagitis or peptic ulcer, by recognizing the diseased area through testing. The patient’s history provides the information that permits the doctor to choose the right test. In the case of the disorders of gastrointestinal function, such as dyspepsia or non-cardiac chest pain, there is no structural abnormality and no diagnostic test. Hence diagnosis of these disorders depends even more upon how the patient describes his or her symptoms. But many people use words to describe symptoms that are vague or misliading to a doctor. Examples are explained – such as indigestion, gas, nausea, chest pain, or vomiting.
105 – Functional Diarrhea – Some Answers to Often Asked Questions
Overview of functional diarrhea, including answers to the following questions: What is diarrhea? What are functional bowel disorders? Is functional diarrhea the same as irritable bowel syndrome? What is the cause of functional diarrhea? What treatments are available for functional diarrhea? Revised and updated 2009.
116 – Doctor – Patient Communication
Functional GI disorders present a special challenge to the doctor-patient interaction for several reasons. First, functional GI disorders are characterized, in most cases, by vague symptoms of variable intensity. Many times, these symptoms involve the most intimate anatomic areas of the body. The sensitivity of these issues can complicate the task for the patient who needs to express them in terms that the physician can interpret to formulate a diagnosis. Secondly, the physician is hampered by the absence of obvious structural lesions that often lessens the likelihood of devising a specific medical intervention that is successful. In some cases, the physician’s own anxiety can be increased by the lack of a symptom complex that leads to well-understood disease entity, such as parasites or lactose intolerance. This deficiency, in turn, often leads both physician and patient to over-investigate the symptoms. So what are the ingredients that comprise successful doctor-patient communication about the functional GI disorders?
215- Problems with Doctors That Interfere with Treatment
The placebo effect can enhance therapy, and promote a successful relationship between healer and patient. However, a treatment administered by a healer may also have a bad effect. Any treatment may have a predictable risk, but a nocebo effect denotes worsening beyond the known risk – the adverse effect of a failed therapeutic relationship. This can result in sub-optimal health care. An examination of its causes and ways to avoid it are discussed.
