A lot of fuss

A lot of fuss

1. Irritable bowel syndrome

   • Common disorder that affects the large intestine.
   • Symptoms
     • Abdominal pain, cramping or bloating that is typically relieved or partially relieved by passing a bowel movement
     • Excess gas
     • Diarrhea or constipation
     • Mucus in the stool
   • Causes
     • Muscle contractions in the intestine
     • Nervous system.
     • Inflammation in the intestines.
     • Severe infection.
     • Changes in bacteria in the gut (microflora).
   • Risk factors
     • Young
     • Female
     • Family history of IBS.
     • Mental health problem

2. Celiac Disease

   • Pathophysiology
     • Histology
   • Epidemiology
   • Risk factors
     • A family member with celiac disease or dermatitis herpetiformis
     • Type 1 diabetes
     • Down syndrome or Turner syndrome
     • Autoimmune thyroid disease
     • Microscopic colitis
     • Addison's disease
     • Rheumatoid arthritis
   • Complications
     • Malabsorptions: Anemia , Osteoporosis
     • Malnutrition : Fatigue , muscle wasting
     • Lactose intolerance : Diarrhea, abdominal discomfort
     • Infertility and miscarriage : Malabsorption of calcium, vitamin D and other vitamins, minerals contribute to reproductive issues.
     • Cancer : T cell lymphoma
     • Neurological manifestations : ranges from neuropathy and ataxia to depression and anxiety
     • Dermatitis herpetiformis
   • Normal Physiology
   • Signs and symptoms & Clinical findings
     • Steatorrhea
     • Evidence of weight loss, including muscle wasting or loose skin folds
     • Failure to thrive in infants and children
     • Pallor due to anemia (often combined anemias)
     • Findings related to water-soluble and fat-soluble vitamin deficiencies
     • Abdominal examination shows a protuberant and tympanic abdomen due to distention of the intestinal loops with fluids and gas. Ascites occasionally can be detected in patients with severe hypoproteinemia.
     • Orthostatic hypotension
     • Ecchymoses
     • Peripheral edema
     • Hyperkeratosis or dermatitis herpetiformis
     • Cheilosis and glossitis
     • Evidence of peripheral neuropathy
     • Chvostek sign or Trousseau sign
   • Investigations and interpretations
     • look for antibodies that the body makes in response to eating gluten
       • Total immunoglobulin A (IgA)
       • IgA Tissue transglutaminase antibody (shortened to tTG)
       • Immunoglobulin G (IgG) EMA
       • IgG deamidated gliadin peptide (DGP)
       • IgG tTG
     • Must be consuming gluten
     • Biopsy
   • What is it?
     • Celiac disease is a serious autoimmune disorder that can occur in genetically predisposed people where the ingestion of gluten leads to damage in the small intestine.
   • Treatment
     • Lifelong Adherence to the Gluten-Free Diet
     • Vitamins and Dietary Supplements

3. Anatomy of small intestine

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