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  1. NOVEMBER 15, 2021 Understanding Postinfection Irritable Bowel Syndrome Anjali Byale, MD Research Trainee Division of Gastroenterology and Hepatology Mayo Clinic Rochester, Minnesota Madhusudan Grover, MD Consultant Division of Gastroenterology and Hepatology Department of Internal Medicine Mayo Clinic Rochester, Minnesota About 1 in 10 individuals develops postinfection irritable bowel syndrome (PI-IBS) after an episode of infectious gastroenteritis. The underlying mechanisms have yet to be fully explored, but both pathogen-associated factors and host responses likely play a role in its pathophysiology. IBS is characterized by abdominal pain related to defecation and changes in the consistency and/or frequency of bowel movements. It has a significant impact on patients’ quality of life, and its high global prevalence (7%-21%) leads to a significant health care burden.1 A universal cause of IBS is unclear, but bidirectional dysfunction of the gut–brain axis results in increased intestinal permeability, visceral hypersensitivity, and dysmotility. Acute gastroenteritis has been identified as one of the strongest risk factors for the development of IBS, with a relative risk of 4 in infected versus uninfected individuals.2,3 Although PI-IBS can develop after bacterial, viral, or parasitic gastroenteritis, the risk is highest with protozoal and lowest with viral gastroenteritis. In a meta-analysis, Klem et al found the most commonly reported phenotype is IBS with mixed symptoms, including constipation and diarrhea (IBS-M), occurring in 46% of patients; this is followed by IBS with diarrhea (IBS-D), occurring in 40%.3 PI-IBS likely results from complex host–pathogen interactions that lead to alterations in intestinal function. In this article, we review the risk factors, pathophysiology, diagnosis, and treatment modalities for PI-IBS. >> Read the full article Copyright © 2004-2022 McMahon Publishing
  2. Trial by Jury: Irritable Bowel Syndrome Brooks Cash, MD ; Lin Chang, MD ; William Chey, MD ; David Kunkel, MD ; Mark Pimentel, MD VIEW WEBCAST Recorded at ACG 2019 meeting in San Antonio, TX. Target Audience: This activity has been designed to meet the educational needs of gastroenterologists and other healthcare providers involved in the care of patients with irritable bowel syndrome (IBS). Educational Objectives After completing this program, participants should be better able to: Design treatment plans for patients with IBS that are aligned with current evidence-based recommendations Explain the quality of evidence, magnitude of benefit, safety, and tolerability of specific treatments for IBS Incorporate new IBS therapies effectively into clinical practice Provided by Supported by educational grants from Salix Pharmaceuticals and Shire. This program is neither sponsored nor endorsed by ACG.
  3. Drossman: Evidence that there may be brain cell death due to the vicious cycle of pain from FGID (Functional Gastrointestinal) condition. Drossman: Validate symptoms, explain thoroughly, & don’t abandon your patients. Chey: Shared “Advice from a patient” from J Ruddy Gastroenterology 2018 Chey: Non-verbal communication is incredibly important in approaching a patient. It gives hope and trust. Chey: We’re still learning about the genetic factors behind IBS Chey: How I describe IBS to patients. With hope, trust and confidence. Chey: Role of Stress & Anxiety in GI Disorders. Anxiety... Is this a chicken and egg situation?? “It’s not all in your head but your head may be playing a role in your symptoms” Chey: Post-infectious IBS (PI-IBS), are we giving patient hope or taking it away? Chey: Potty talk. How you can talk to patients about pooping. Chey: Rodin’s “The Thinker” might just be the perfect position to have a good bowel movement! Chey: Create a spirit of collaboration. “What matters is what the patient takes away from you.” Chey: Give your patients hope.
  4. From Pretending to Truly Being OK: A Journey From Illness to Health With Postinfection Irritable Bowel Syndrome: The Patient’s Perspective Johannah Ruddy Rome Foundation, Raleigh, North Carolina Pain is something we all experience. Growing up the oldest in a conservative, protestant, middle class family you had to tolerate pain and learn to deal with it. Getting sick was not an excuse for sympathy or a day off from school. It was almost a badge of honor because you were tough, not weak like others. Maybe that’s why, at the age of 13, when it finally came out that I was sexually abused for 4 years by my cousin, I held back communicating my deepest thoughts and feelings about the experience. Rather, I felt the need to express to my mother that I was okay, even though I wasn’t. I was a “good girl,” but was dying on the inside, and I still had to show I was okay. So, I stuffed down the emotional pain and moved on to college. I married a great guy, had 2 kids, and with great passion I started a career in health and social justice nonprofits. Although I could help vulnerable, oppressed, and ill people in similar situations, I could not reverse the trauma in my own life. I also managed through more than a dozen surgeries, the care of my son with congenital health issues, and saw family members through attempted suicides, cancer diagnosis, and death. Through it all, I had to be OK. Full story: https://www.gastrojournal.org/article/S0016-5085(18)35212-0/fulltext © 2018 by the AGA Institute
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