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Pathophysiology
Different digestive disorders can be confused due to the presence of the same or highly similar symptoms; examples are inflammatory bowel disease (IBD) and irritable bowel syndrome (IBS). In the comparison between the disorders, it is primarily necessary to address pathophysiological processes. The term IBD encompasses several conditions, primarily including ulcerative colitis and Crohn disease.
The pathophysiology of ulcerative colitis includes inflammation in the large intestine, abscess, ulceration of the mucosa ensue, and mucosal destruction (Huether & McCance, 2017). The pathophysiology of Crohn disease includes inflammation in intestinal submucosa, ulcerations, granulomata, and fistulae in various areas. IBS, Huether, and McCance (2017) state that the “pathophysiology of IBS is unknown and there are no specific biomarkers for the disease” (p. 922).
Hammer and McPhee (2014) suggest explaining the disease by “alterations insensitivity of the extrinsic and intrinsic nervous systems of the intestine” (p. 378). The syndrome may be associated with altered intestine microflora or immune reactions. Both IBD and IBS can cause abdominal pain, diarrhea, and constipation; however, patients with the former disease are much more likely to have rectal bleeding, while patients with the latter disease are less likely to experience fatigue due to their condition.
Treatment
Treatment of ulcerative colitis will depend on the extent to which mucosa is affected; therefore, treatment is individual, and parenteral nutrition and surgery may be needed in some cases. In less severe cases, however, a drug therapy involving “5-aminosalicylate therapy followed by steroids” (Huether & McCance, 2017, p. 921) may be sufficient. Antibiotics are effective in most cases. Similarly, Crohn disease diagnosis does not imply definitive treatments.
For initial therapy, immunomodulators should be administered. In severe cases (e.g. involving abscess or fistulae), surgery may be needed. IBS is not classified as a disease; one of the reasons is that its causes cannot be identified (Hammer & McPhee, 2014). It is classified as a functional disorder instead; therefore, treatment is not aimed at healing a condition but at eliminating the symptoms.
Therefore, a particular patient’s treatment can include laxatives, antidiarrheals, antispasmodics, and prosecretory drugs. Based on the above, it can be concluded that, if a patient is diagnosed with IBD when he or she has IDS (or vice versa), treatment for the diagnosed condition will not necessarily come into conflict with treatment that is required. Treatments for all the conditions described above are individualized; therefore, with a properly designed medication plan and necessary medication safety measures, the risk that the effects of the misdiagnosis will be dramatically negative is rather low.
Behavior
Finally, the factor of patients’ behavior in the two conditions’ pathophysiology and treatment should be addressed. In the case of digestive disorders, the factor of behavior primarily refers to diet. Although IBD and IBS are not among conditions that are directly linked to certain products or types of products, it can be argued that some correlations between diet and pathophysiology exist; for example, high protein intake increases the risk of being affected by IBD (Andersen, Olsen, Carbonnel, Tjønneland, & Vogel, 2012).
In IBS treatment, behavior can play even a more significant role. For example, if a patient is diagnosed with IBS (while having IBD), he or she may opt for using the methods of alternative medicine (Grundmann & Yoon, 2014). This is particularly likely because IBS is not a disease and cannot be cured, which is why many patients diagnosed with it feel confused and start searching for unconventional solutions. The methods they use may adversely affect their condition and worsen their IBD.
References
Andersen, V., Olsen, A., Carbonnel, F., Tjønneland, A., & Vogel, U. (2012). Diet and risk of inflammatory bowel disease. Digestive and Liver Disease. 44(3): 185–194.
Grundmann, O., & Yoon, S. L. (2014). Complementary and alternative medicines in irritable bowel syndrome: An integrative view. World Journal of Gastroenterology, 20(2), 346-362.
Hammer, G. G., & McPhee, S. (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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