The Concept of Digestive Disorders: IBD and IBS

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Introduction

The fact that multiple digestive disorders are similar to each other poses a challenge to nurses. Inflammatory bowel disease (IBD) that includes ulcerative colitis and Crohn’s disease and irritable bowel syndrome (IBS) have many common traits in clinical presentation and etymology. However, their pathophysiological mechanisms differ, thus resulting in patients needing a particular treatment for each condition. One of the patient factors that affect the development of both disorders is behavior – people’s dietary choices and nutrition play a significant role in exacerbating and treating both IBD and IBS. Such digestive disorders as IBD and IBS have many common characteristics and symptoms and are affected by patients’ diet.

Pathophysiology

Behavioral and genetic factors have an impact on the development of IBD. According to Hammer and McPhee (2014), some people possess unique genes that increase the susceptibility of their body for both variations of IBD. Moreover, various bacteria and viruses, as well as smoking, food, and mental health problems can also lead to the progression of the condition (Huether & McCance, 2017). In IBD, the intestine cannot respond to the antigens introduced with foods and bacteria because it loses the necessary immune tolerance. As a result, each encounter with these antigens leads to the organ’s inflammation, lesions, and ulceration.

The pathophysiology of IBS is connected to motility and interaction of one’s brain and gut (Chey, Kurlander, & Eswaran, 2015). However, the causes of abnormal motility are not understood by the specialists fully. They may occur due to a variety of factors and lead to an increase in gut bacteria and antibodies, resulting in inflammatory processes (Hammer & McPhee, 2014). The main similarity of these processes is the abnormal response of the gut flora to food and bacteria. However, IBS is also characterized by muscle contraction abnormalities.

Common Treatments

The treatment plan for IBD usually includes drug therapy and lifestyle changes. Anti-inflammatory medications are used to treat this disorder, but each specific drug may be more or less useful for one type of IBD than another. Corticosteroids and immunosuppressant drugs are utilized to control exacerbations (Huether & McCance, 2017). Some patients with IBD may require surgery to remove the affected part of the intestine – this is a treatment that is not used for IBS. Moreover, patients with IBD have to quit smoking and change their diet to exclude foods that worsen their bowel response.

IBS also requires dietary changes, but the use of medications is not required for some individuals (Hammer & McPhee, 2014). A low FODMAP diet can be recommended to persons with IBS – it excludes foods that have “fermentable oligosaccharides, disaccharides, monosaccharides, and polyols” (Chey et al., 2015, p. 954). Also, people with IBS may benefit from lowering the intake of gluten-rich foods. Other lifestyle changes include physical exercise, stress reduction, and symptom management (Chey et al., 2015). Clinicians can utilize over-the-counter medications to reduce the severity of pain, diarrhea, and bloating.

Patient Factor

As it was noted above, a person’s behaviors can contribute to the development of both IBD and IBS. People who consume heavily processed foods, additives, and products rich in FODMAP are more likely to acquire digestive problems (Dixon, Kabi, Nickerson, & McDonald, 2015). Moreover, the lack of foods high in fiber in the diet can also exacerbate one’s problems with digestion. Diet changes are also detrimental to the treatment plan for both IBS and IBD. In the case of IBS, this is the primary strategy to reduce pain and bloating.

Conclusion

Digestive disorders are challenging to treat because their pathophysiology is not researched well enough to determine all causes and processes of the disorders. Both IBD and IBS affect the person’s intestine, but IBD is characterized by immune responses, while IBS is closely connected to abnormalities in motility. Nevertheless, both conditions are affected by the individual’s dietary choices – a low FODMAP diet can decrease the severity of bowel inflammation and prevent exacerbations. IBD is also treated with medication and surgery, and the strategy for IBS maintenance includes psychosocial interventions and physical activity.

References

Chey, W. D., Kurlander, J., & Eswaran, S. (2015). Irritable bowel syndrome: A clinical review. JAMA, 313(9), 949-958.

Dixon, L. J., Kabi, A., Nickerson, K. P., & McDonald, C. (2015). Combinatorial effects of diet and genetics on inflammatory bowel disease pathogenesis. Inflammatory Bowel Diseases, 21(4), 912-922.

Hammer, G. D., & McPhee, S. J. (2014). Pathophysiology of disease: An introduction to clinical medicine (7th ed.). New York, NY: McGraw-Hill Education.

Huether, S. E., & McCance, K. L. (2017). Understanding pathophysiology (6th ed.). St. Louis, MO: Mosby.

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