Alimentary Pharmacology Therapeutics, Essay Example

Introduction

A 21 year-old Caucasian patient of normal weight presented at the clinic with intermittent periods of constipation and diarrhea, pain in her lower quadrant, and frequent gas and bloating over the past three months, with little relief when using over the counter medications. She also noted that she has experienced fatigue in recent weeks, but figured that it might be related to studying for her college finals. The patient presented with a prior medical history that included irregular menstrual periods over the past six months. She has no other prior episodes of lower quadrant pain, intense gas or bloating, or significant periods of diarrhea and constipation that she recalls. The patient did not have any prior history of surgery, had been treated for a broken arm at the age of 12, and was currently taking a multivitamin and ibuprofen on an as-needed basis. She was not currently taking any other medications.

Analysis

The patient’s temperature was 37.1 degrees Celsius, her blood pressure was 115/73, and her pulse was 72. She appeared slightly pale and her hands were cool to the touch. Based on the length of her symptoms, her feeling of bloating, and her irregular menstrual periods, and the use of the Rome Criteria (Mayo Clinic, 2014), the patient was diagnosed with irritable bowel syndrome (IBS). Furthermore, her CBC values were listed as follows: Hemoglobin: 10.1 g/dL, Hematocrit: 34 percent, and serum iron: 54 mcg/dL. These values indicated mild iron-deficiency anemia (The New York Times, 2014). The patient noted that her diet does not consist of meat, as she is a vegetarian, but she also does not consume a sufficient amount of green vegetables, which may be contributing factors in her anemia diagnosis.

One issue that is relevant to women with IBS is its association with irregularity in menstrual periods in some cases (WebMD, 2014). In this case, the patient’s anemia is also a likely contributing factor, although her irregular periods are likely to be primarily associated with her IBS condition (WebMD, 2014). It is believed that male and female patients may experience different symptoms associated with IBS, and these are often attributed to the prominence of female hormones in patients (Adeyemo et.al, 2010). As a result, she is likely experiencing an exacerbation of symptoms, including irregular periods, as a result of her condition (Adeyemo et.al, 2010).

For this patient, the most logical treatment method is to adjust the diet accordingly by recognizing possible trigger foods, such as high fat foods, caffeinated products, and milk-based products (NIDDK, 2013). Once these food triggers are identified, they should be minimized or removed from the diet altogether for a period of time until a greater diet balance is achieved (NIDDK, 2013). Furthermore, during periods of constipation, fiber supplements are necessary, while loperamide may be used when there is evidence of diarrhea (NIDDK, 2013). The patient’s anemic condition must be addressed through an increase in green leafy vegetables and other foods that are rich in iron.

Conclusion

In this example, the patient’s diagnosis of IBS is not unusual, but it poses a number of challenges for the patient and her busy lifestyle. Her diagnosis and treatment were not gender-specific, other than the discussion of her irregular menstrual periods. This information is relevant because it enables clinicians to diagnose the condition and to also examine other factors that may contribute to the condition, such as any gender-specific characteristics that may be evident. This promotes a more definitive diagnosis and approach to treatment as necessary. For this patient, her current quality of life is less than optimal; therefore, adjustments to her diet and medication therapies are necessary to address the condition and to manage the condition over time.

References

Adeyemo, M. A., Spiegel, B. M. R., & Chang, L. (2010). Meta?analysis: do irritable bowel syndrome symptoms vary between men and women?. Alimentary pharmacology & therapeutics, 32(6), 738-755.

Mayo Clinic (2014). Irritable bowel syndrome. Retrieved from http://www.mayoclinic.org/diseases-conditions/irritable-bowel-syndrome/basics/tests-diagnosis/con-20024578

National Institute of Diabetes and Digestive and Kidney Diseases (2013). Irritable bowel syndrome. Retrieved from http://digestive.niddk.nih.gov/ddiseases/pubs/ibs/#treatment

The New York Times (2014). Anemia. Retrieved from http://www.nytimes.com/health/guides/disease/anemia/diagnosis.html