Transcript INFECTIONS AND IRRITABLE BOWEL SYNDROME (IBS)

INFECTIONS
AND IRRITABLE BOWEL
SYNDROME
(IBS)
By Pebbles Miller
What Are Intestinal Infections
Viruses, bacteria, parasites, or other
pathogens ( microscopic organisms that
cause disease) can cause infections in the
stomach and small and large intestines,
which often lead to gastroenteritis, and
diarrhea.
Gastroenteritis is an inflammation of the
gastrointestinal tract.
Intestinal infections are very common,
particularly in developing parts of the world.
 The World Health Organization (WHO)
estimates that about 2 million children worldwide
die each year from diseases that cause
diarrhea.
Children, the elderly, and people who have weak
immune systems are most likely to contract
intestinal infections.
What Bacteria Cause Intestinal
Infections ?
Clostridium difficile infection
can produce fever, watery diarrhea, abdominal
pain, and loss of appetite.
Risk factors for infection include taking
antibiotics, a hospital stay, gastrointestinal
surgery, and having another serious illness.
Health care workers often spread the bacteria
when they touch infected feces or contaminated
surfaces, then touch patients or give them
medicine without first washing their hands.
•
•
•
Figure 2. Irregular yellow plaques of necrotic debris (black arrow) with intervening
edematous bowel mucosa (white arrow) in an 87-year-old woman. These findings
are consistent with pseudomembranes caused by Clostridium difficile infection.
C. difficile will overgrow from a lack of normal flora due to treatment with
antibiotics.
This causes an inflammation called antibiotic associated pseudomembranous
colitis(AAPMC).
• Salmonella
• Shigella
• E.coli 0157:H7
•
Campylobacter
• These bacteria produce toxic substances ,
and mucosal cells respond by secreting
water and electrolytes, causing an
imbalance.
• The amount of fluid secreted exceeds the
ability of the large intestine to reabsorb the
fluid into the vascular system.
• This causes diarrhea
Important stuff
• Pt. will complain of
diarrhea, rectal urgency,
abdominal cramping.
• They will have a fever
higher than 102°F, and
vomiting.
• A stool culture is done,
and possibly a blood
chemistry to monitor
electrolyte ∆’s
• Conditions are treated
with antibiotics:
clindamycin, ampicillin, &
amoxicillin,
• Flagyl is the drug of
choice for AAPMC
• Pepto-Bismol can
effectively ↓intestinal
secretoins & diarrhea vol.
• Electrolyte replacement if
necessary.
The Nurse should…
1. Do a thorough assessment: determining
onset, severity, and the number of people
exposed.
2. Instruct Pt. to keep track of bowel
movements & its characteristics
3. Teach Pt. and family the importance of
handwashing after bowel movements
and handling raw meats ( cook meat
thoroughly).
Prognosis
• Good. Especially w/ early treatment.
• The body may be able to successfully
defend against infection w/o intervention.
• In other cases meds. and fluid
replacement is needed.
Irritable Bowel Syndrome
• irritable bowel syndrome (IBS) or spastic
colon is a functional bowel disorder
characterized by abdominal pain and changes in
bowel habits which are not associated with any
abnormalities seen on routine clinical testing.
• It is fairly common and makes up 20–50% of
visits to gastroenterologists.
• Lower abdominal pain, and bloating associated
with alteration of bowel habits and abdominal
discomfort relieved with defecation are the most
frequent symptoms.
3 Types
Diarrhea,
constipation, or both
♫ Diarrhea-predominant:
♫ ConstipationAt least 1 of B, D, F and
predominant: At least 1
none of A, C, E; or at
of A, C, E and none of B,
least 2 of B, D, F and one
D, F; or at least 2 of A, C,
of A or E.
E and one of B, D, F
A) Fewer than three bowel movements a week
B) More than three bowel movements a day
C) Hard or lumpy stools
D) Loose (mushy) or watery stools
E) Straining during a bowel movement
F) Urgency (having to rush to have a bowel movement)
G) Feeling of incomplete bowel movement
H) Passing mucus (white material) during a bowel
movement
I) Abdominal fullness, bloating, or swelling
۩ IBS is not a disease. It's a functional disorder,
which means that the bowel doesn't work as it
should.
۩ With IBS, the nerves and muscles in the bowel
are extra-sensitive. For example, the muscles
may contract too much when you eat. These
contractions can cause cramping and diarrhea
during or shortly after a meal.
۩ Or the nerves can be overly sensitive to the
stretching of the bowel (because of gas, for
example). Cramping or pain can result.
Causes of IBS
Milk
Products
Fatty
Foods
Alcohol
Causes of
IBS
Hypersensitive
bowel
Spiced foods
Associated Psych
Probs.
Medical Tests for IBS
• Physical exam
• Blood tests
• X ray of the bowel: This x-ray test is called a barium enema or lower
GI (gastrointestinal) series. Barium is a thick liquid that makes the
bowel show up better on the x ray. Before taking the x ray, the doctor
will put barium into your bowel through the anus.
• Endoscopy: The doctor inserts a thin tube into your bowel. The tube
has a camera in it, so the doctor can look at the inside of the bowel
to check for problems.
What is the treatment?
• IBS has no cure, but you can do things to
relieve symptoms. Treatment may involve
• diet changes
• medicine
• stress relief
• You may have to try a combination of
things to see which works best for you.
Things that make it
better
• Here are some examples of foods with fiber:
• Fruits,vegetables,breads, cereals, and beans,
• Apples
Peaches
• Broccoli, raw
Cabbage
Carrots, raw
Peas; Kidney beans
Lima beans
• Whole-grain bread
Whole-grain cereal
Med. Management
• Medicine
• If necessary, the doctor might give you medicine to help with
symptoms:
• laxatives: to treat constipation
• antispasmodics: to slow contractions in the bowel, which helps
with diarrhea and pain
• antidepressants: to help those who have severe pain
• Medicine
• If necessary, the doctor might give you medicine to help with
symptoms:
• laxatives: to treat constipation
• antispasmodics: to slow contractions in the bowel, which helps
with diarrhea and pain
• antidepressants: to help those who have severe pain
• Medicine
•
• If necessary, the doctor might give you medicine to help with
symptoms:
• laxatives: to treat constipation
• antispasmodics: to slow contractions in the bowel, which helps
with diarrhea and pain
• antidepressants: to help those who have severe pain