Extra Credit: Digestive Disorders---Case Studies
Extra Credit: Digestive System Disorders
Case study 1: Arlo has avoided spicy foods for several years. He claims that they make his stomach hurt. However, his wife finally persuades him to go see a doctor as the pain is more frequent, and over-the-counter treatments (like antacids) only work short term. A blood test reveals that Arlo has a bacterial infectionâfrom a bacterium called H. pylori---a common cause of this condition. Arlo is treated with antibiotics, PPIs (proton pump inhibitors to reduce stomach acid), and histamine blockers. He takes the medications for two full weeks, and does feel much better.
- What is Arloâs condition? Why is he given three medications during the treatment?
Case study 2: Maryanne has a condition that causes her frequent discomfort and symptoms. However, her condition is not a disease, but a group of symptoms reflecting both physical and emotional causes expressed by GI tract functions. This condition can take several forms, but Maryanne has the type called âmixedâ, where she has constipation at least 25% of the time, and diarrhea at least 25% of the time. She experiences periods of feeling bloated, that she isnât always completely able to pass a stool. Sometimes she will produce mucous secretions passed with stool, (the mucus is produced by the bowel to protect itself against inflammation). There is no one unifying explanation for the causes of Maryanneâs conditionâfor years sufferers were told it was all âin their headâ and that they were making up symptoms. It is now thought that in addition to anxiety or stress responses, gut motility may be abnormal in people with this condition, and that there may be poor communication between the brain and the gut. Maryanneâs symptoms worsen during her menstrual periods, and it is thought that reproductive hormones do play a role in this condition for women who are not yet menopausal. Symptoms improve after menopause, typically. Maryanne is told to keep a food diary to see if any foods worsen her symptoms, to increase her intake of dietary fiber (which can help relieve constipation and provide healthy bulk to her stools), to reduce alcohol and caffeine sources, and has antidiarrheal medications she can use. She is also put on an antidepressant to see if this will help improve her symptoms.
- What is Maryanneâs condition? People with her condition also often have other GI diseases such as GERD. What is GERD? Why is it important to treat GERD, and not just use over-the-counter medications?
Case study 3: Beth was diagnosed with this condition when she delivered her first baby (she had a very difficult time getting pregnant). It is a genetic illness, and does run in Bethâs family. ( One in 133 people have this illness in the U.S., but it is a common genetic condition found around the world.) Digestive symptoms may have been present when Beth was younger (she remembers a lot of stomach aches and abdominal pain as a child), but now her issues are persistent iron-deficiency anemia that can be treated but recurs. She also has joint pains, recently diagnosed as arthritis. Beth is breast-feeding her infant and hopes to do so for at least a full year, as breast feeding seems to reduce risks for this condition in children. Although the baby has no symptoms, Beth is introducing only wheat-free foods, and is careful to read all food labels---she does this for herself, too, as she tries to avoid a protein found in wheat. The less of this protein she eats, the better for her. Other potential risks for Beth are osteoporosis, and even risks for thyroid or liver disease.
- What is Bethâs condition? What treatments can be of benefit to Beth? Why is dietary treatment often difficult with this condition?
Extra Credit: Digestive Disorders---Case Studies
Extra Credit: Digestive System Disorders
Case study 1: Arlo has avoided spicy foods for several years. He claims that they make his stomach hurt. However, his wife finally persuades him to go see a doctor as the pain is more frequent, and over-the-counter treatments (like antacids) only work short term. A blood test reveals that Arlo has a bacterial infectionâfrom a bacterium called H. pylori---a common cause of this condition. Arlo is treated with antibiotics, PPIs (proton pump inhibitors to reduce stomach acid), and histamine blockers. He takes the medications for two full weeks, and does feel much better.
- What is Arloâs condition? Why is he given three medications during the treatment?
Case study 2: Maryanne has a condition that causes her frequent discomfort and symptoms. However, her condition is not a disease, but a group of symptoms reflecting both physical and emotional causes expressed by GI tract functions. This condition can take several forms, but Maryanne has the type called âmixedâ, where she has constipation at least 25% of the time, and diarrhea at least 25% of the time. She experiences periods of feeling bloated, that she isnât always completely able to pass a stool. Sometimes she will produce mucous secretions passed with stool, (the mucus is produced by the bowel to protect itself against inflammation). There is no one unifying explanation for the causes of Maryanneâs conditionâfor years sufferers were told it was all âin their headâ and that they were making up symptoms. It is now thought that in addition to anxiety or stress responses, gut motility may be abnormal in people with this condition, and that there may be poor communication between the brain and the gut. Maryanneâs symptoms worsen during her menstrual periods, and it is thought that reproductive hormones do play a role in this condition for women who are not yet menopausal. Symptoms improve after menopause, typically. Maryanne is told to keep a food diary to see if any foods worsen her symptoms, to increase her intake of dietary fiber (which can help relieve constipation and provide healthy bulk to her stools), to reduce alcohol and caffeine sources, and has antidiarrheal medications she can use. She is also put on an antidepressant to see if this will help improve her symptoms.
- What is Maryanneâs condition? People with her condition also often have other GI diseases such as GERD. What is GERD? Why is it important to treat GERD, and not just use over-the-counter medications?
Case study 3: Beth was diagnosed with this condition when she delivered her first baby (she had a very difficult time getting pregnant). It is a genetic illness, and does run in Bethâs family. ( One in 133 people have this illness in the U.S., but it is a common genetic condition found around the world.) Digestive symptoms may have been present when Beth was younger (she remembers a lot of stomach aches and abdominal pain as a child), but now her issues are persistent iron-deficiency anemia that can be treated but recurs. She also has joint pains, recently diagnosed as arthritis. Beth is breast-feeding her infant and hopes to do so for at least a full year, as breast feeding seems to reduce risks for this condition in children. Although the baby has no symptoms, Beth is introducing only wheat-free foods, and is careful to read all food labels---she does this for herself, too, as she tries to avoid a protein found in wheat. The less of this protein she eats, the better for her. Other potential risks for Beth are osteoporosis, and even risks for thyroid or liver disease.
- What is Bethâs condition? What treatments can be of benefit to Beth? Why is dietary treatment often difficult with this condition?
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