Who are at risk for foreign body ingestion? Eighty percent of foreign-body ingestions occur in children, whereas almost all foreign bodies inserted into the rectum are described in adults. Groups at increased risk for foreign-body ingestion include psychiatric patients, prisoners, and those who frequently and excessively use alcohol or sedative-hypnotic medications. Also at risk are …
How common are foreign bodies in the gastrointestinal (GI) tract? Every year, millions of foreign bodies enter the GI tract through the mouth or anus, and approximately 1500 to 3000 people die from their ingestion. However, only approximately 10% to 20% of foreign bodies require removal through some form of therapeutic intervention; the rest pass …
What is the role of cognitive behavioral therapy in IBS? Cognitive-behavioral therapy is the best-studied psychological treatment for IBS. Cognitive techniques (typically administered over 4 to 15 sessions) are aimed at changing catastrophic or maladaptive thinking patterns underlying the perception of somatic symptoms. Behavioral techniques aim to modify dysfunctional behaviors through relaxation techniques, contingency management …
What is the role of loperamide in IBS? Loperamide is a synthetic peripheral opioid agonist that reduces gut transit. By binding to the μ opioid receptors on the myenteric neurons in the upper and lower bowel, loperamide reduces gut motility, which allows for greater fluid absorption and improved stool consistency. Loperamide does not cross the …
What is the pharmacologic approach in treating IBS? Pharmacologic treatment of IBS has traditionally been aimed at treating and preventing the predominant symptoms, such as diarrhea, constipation, and abdominal pain. Pharmacologic treatment options for patients who report diarrhea as their predominant symptom include antidiarrheals, such as loperamide, diphenoxylate, cholestyramine, or alosetron. For patients who report …
Can exercise improve IBS symptoms? Physical activity has been shown to have a number of positive physiologic and psychological effects. In the GI tract, exercise can increase overall gut motility, including colonic motility and colon transit time. In a recent study, 12 weeks of moderate to rigorous exercise (20-60 minutes three times per week) resulted …
What is the FODMAP diet? FODMAPs are fermentable oligo-, di-, and monosaccharides and polyols that are poorly absorbed in the small intestine. A diet high in FODMAPs has been associated with higher levels of hydrogen produced in the breath in both IBS patients and healthy individuals as well as GI symptoms and lethargy in IBS …