Irritable Bowel Syndrome Health And Social Care Essay

Irritable bowel Syndrome Health And Social Cargon EssayThis essay aims to provide a comprehensive account of the gastrointestinal disorder, Irritable Bowel Syndrome. The aetiology, pathology, and prognosis of the disorder will be described, along with details pertaining to its epidemiology. The diagnosis and caution of the disorder will be described, followed by a discussion of the wellness implications envisiond by patients and the economic be of the disorder. Conclusions will be made based on the learning and evidence discussed by means ofout the essay.Irritable Bowel Syndrome (IBS), overly known as spastic colon, nervous licentiousness, and running(a) catgut, is one of the most common gastrointestinal disorders worldwide (NICE, 2008). It is a chronic, functional disorder of the gastrointestinal portion which is characterised by symbols of type AB torture or discomfort of the lower abdomen, bloating, and disorde wild defecation (Silk, 2003). This latter symptom appr ise manifest in four different forms (Allison, 2002) constipation predominant diarrhoea predominant alter mingled with constipation and diarrhoea or, non-extreme. Further more(prenominal), although symptoms ar predominantly gastrointestinal, other symptoms washbasin include back ache, na intentiona, heartburn, lethargy, urinary problems, faintness, palpitations, and loss of appetite (Fortson and Lee, 2004). Symptoms are usually worse after eating and most people experience flare-ups lasting between 2-4 days. Indeed, a key characteristic of IBS is a cycle of turn and remission (Silk, 2003).Worldwide, IBS affects an estimated 10-20% of the universe of discourse at any one time, although the figure may be higher because not all(prenominal)one seeks help for the cast (Hungin et al. 2003 Hungin et al., 2005). IBS bum affect both genders of all ages, although it is twice as common in females (Voci and Cramer, 2009). It can spend at any age, but typically develops in individuals who are 20-30 stratums old (Wangen, 2006). Incidence tends to lose lading with age (Wilson et al., 2004). Furthermore, more women report constipation predominant IBS, while more men report diarrhoea predominant IBS (Heitkemper and Jarrett, 2001). Women also tend to report a worsening of symptoms during menstruation, suggesting a hormonal link with IBS (Moore et al., 1998). despite there being no clear aetiology for IBS, there is a world(a) consensus that it is a complex disorder of a biopsychosocial nature (Allison, 2002). Possible factors involved in its development include an abnormality with how the muscles run away food through the digestive tract, pain-sensitive digestive organs, a malfunctioning immune system, a problem between the central nervous system and the digestive system, or an abnormal response to infection. Environmental, dietary, and genetic factors that are as yet known are also suspected to play a role in the aetiology of IBS.DiagnosisA diagnosis of IBS can be made using the Rome III criteria of red flag symptoms (Paterson et al., 1999). According to these criteria, an individual is diagnosed with IBS if they have experienced, for at least 6-months, any of the following symptoms abdominal pain or discomfort bloating or, change in bowel habit. In addition, the individual has to present with abdominal pain or discomfort that is relieved by defecation or associated with changes in bowel frequency or stool formation, and have at least two of the following altered stool evacuation (i.e. straining, urgency, neither evacuation) abdominal bloating (i.e. distension, tension, or hardness) symptoms made worse by eating mucus from the rectum. Reported lethargy, nausea, backache and bladder symptoms are also indicators that might inform a diagnosis of IBS. Furthermore, there are a number of tests that are carried out to exclude other diagnoses. These include a full blood count, erythrocyte sedimentation yard or plasma viscosity (screening test), c-reactive protein (found in blood), and, antibody testing for coeliac disease (RCN, 2008).The red flag symptoms that shoot the individual to be referred to secondary business for further investigation include unintentional and unexplained weight loss, rectal bleeding, and, a family history of bowel or ovarian cancer (NICE, 2008). In people antiquated 60-years or over, a change in bowel habit lasting more than 6-weeks with looser and/or more frequent stools also acts a red flag. Other indicators for referral include anaemia, abdominal or rectal masses, and seditious markers for inflammatory bowel disease (NICE, 2008).TreatmentThere is no cure for IBS, but it can be managed and controlled through animatenessstyle changes and medicine. NICE provide clinical guidelines on the management of IBS in primary care, which were substantial through input from the National Collaborating Centre for Nursing and Supportive Care (NCC-NSC). These guidelines include the provision of general li festyle advice, particularly in terms of dietary and physical activity advice (NICE, 2008). The treatment and management of IBS is for the most part focused on providing individuals with the information required to self-manage their condition through diet, physical activity, and medication for specific symptoms. dietetical advice includes having regular meals, taking time to eat, drinking at least eight cups of water daily, and restricting exercise of tea, coffee, alcohol, fizzy drinks, high-fibre foods, resistant starch (i.e. whole grains, legumes, seeds), and fresh fruit. Individuals with diarrhoea are advised to avoid sorbitol, which is an synthetic sweetener found in sugar-free sweets and drinks. Individuals with wind and bloating, on the other hand, are advised to increase white plague of oats and linseeds. If diet is assessed as being a key factor in the IBS symptoms, the individual is referred to a nutritionist for single food avoidance and exclusion diets.In terms of ph ysical activity, individuals who score low in physical activity on the General Practice Physical Activity Questionnaire (GPPAQ) are provided with brief advice and instruction aimed at increasing their activity. The importance of physical activity in the management of IBS cannot be underestimated. Indeed, a remove conducted in Sweden demonstrated that even a minimal increase in physical activity can improve symptoms of IBS (n=102) (Johannesson et al., 2011).First-line pharmacological treatment is dependent on the primary symptoms reported by the individual. For example, there is patronise for the provision of antispasmodic agents such(prenominal) as hyoscine or peppermint oil to control symptoms of abdominal pain and spasms (Ford, 2008). Laxatives are an option for constipation, whilst loperamide is the recommended first choice of antimobility agent for diarrhoea (NICE, 2008). Second-line pharmacological treatment includes the shape of tricyclic antidepressants for mood and analg esic (pain relieving) effect if first-line treatments do not work (Bell, 2004). Selective serotonin reuptake inhibitors are considered if tricyclic antidepressants do not work. However, due to the potential side-effects of these second-line medications, follow-up after 4-weeks and then every 6-12 months is advised (NICE, 2008).Psychological ImplicationsIf individuals with IBS do not respond to second-line pharmacological treatments after 12-months, referral for psychological support such as cognitive behavioural therapy (CBT), hypnotherapy, or psychotherapy requires consideration (NICE, 2008). Indeed, although it is not a life-threatening condition, IBS can response in a great deal of psychological distress. One study found that half of the patients attending IBS clinics presented with a diagnosable psychiatric disorder (Silk, 2003). Anxiety and depression have been reported in people with IBS and stress and major life events have been found to often precede the onset of bowel sym ptoms (Silk, 2003). Strong associations have been found between IBS and Generalised Anxiety Disorder (GAD), with this comorbidity adding to social impairments (Lee et al., 2009). There is also a higher prevalence of childhood physical and sexual abuse among individuals diagnosed with IBS, further indicating the potential force of providing psychological support (Allison, 2002).The psychological impact of IBS is likely to result from that fact that it can be extremely debilitating and can severely impact quality of life (Heitkemper and Jarrett, 2001). Activities of daily living can be detrimentally impacted and individuals with IBS often experience lethargy and fatigue, which can limit physical activity and social life (Jones et al., 2000). Bertram et al. (2001), who conducted focus groups with people diagnosed with IBS, found that the condition resulted in high levels of frustration and social isolation. There was also an inconsistency in how individuals with IBS perceived their i llness and how they felt others perceived their illness. In particular, there was frustration with a lack of understanding from family, friends, and colleagues in terms of the severity and unpredictability of the illness. Many participants also felt that health care professionals did not take the illness seriously. There is some evidence, however, to suggest that health professionals attitudes towards IBS are changing. In a study conducted by Nunn (2003), the majority of nurses disagreed with a statement suggesting that patients with IBS were demanding and lazy.Nevertheless, the stigma surrounding IBS can result in individuals with IBS not accessing the support they need. When combined with the general lack of effective treatments for IBS, people often soften to treat themselves. It has been estimated that 50% of people with IBS use complementary and alternative medicine (Hussain and Quigley, 2006). The NICE (2008) guidelines on the use of complementary and alternative medicine, ho wever, recommend against encouraging their use, especially acupuncture and reflexology.Economic ImplicationsEvidence suggests that disease relapse and remission accounts for 36-50% of all gastrointestinal consultations, although many patients do not seek help and often judge to self-treat (Gunn et al., 2003 Parker, 2004). IBS has a significant impact on healthcare resources in both primary and secondary care (Ringstrom et al., 2007). It also contributes to both groom and indirect costs. Evidence suggests that disease relapse and remission accounts for 36-50% of all gastrointestinal consultations, although many patients do not seek help and often attempt to self-treat (Gunn et al., 2003 Parker, 2004).IBS can lead to increase absenteeism at work and higher rates of health care utilisation, making it a public health problem (Talley, 2008). In a systematic review of the economic cost of IBS in the UK and US, total direct cost estimates per patient per year ranged from $348-8750 (211.7 9-5325.25) (calculated for year 2002) (Maxion-Bergemann, Thielecke, and Bergemann, 2006). The average number of days off work per year because of IBS was between 8.5 and 21.6 indirect costs ranged from $355-3344 (216.25-2037.04). Of note, however, is that the total costs and cost components of IBS were influenced by factors such as the demographic of the patient group and study variables, such as design and databases used. Further research is needed on the cost-effectiveness of diagnostic procedures andtreatments for IBS in order to help define strategies to help IBS patients improve their quality of life and, in turn, reduce related healthcare and economic costs.ConclusionThis essay has outlined the aetiology and epidemiology of Irritable Bowel Syndrome, which is one of the most common gastrointestinal disorders worldwide. IBS is a chronic disorder that cannot be cured, but requires self-management through lifestyle, pharmacological treatments, and psychological support. The direct and indirect costs of the condition are vast due to the backsliding and remitting nature of the symptoms. Due to there being no clear cause for IBS, stigma still exists regarding its seriousness, which can prevent people seeking medical support. In order to reduce the direct and indirect costs of this common, quality of life depleting illness, healthcare professionals need to take it seriously and assist patients in the long-term management of the physically and psychologically limiting symptoms.