Jordan is a 35-year-old woman who presents with intermittent diarrhea with cramping that is relieved by defecation. The diarrhea is not bloody or accompanied by nausea and vomiting. Review of past medical history includes some childhood “stomach issues”, HTN, and a recent cholecystectomy. She works in the environmental department of a large hotel. . She denies alcohol and cigarette.

Diagnosis: Irritable Bowel Syndrome (IBS)

I.      Discuss the epidemiology of IBS?

II.     What is your treatment goals for this patient?

III.    Discuss First line and second line drug therapy for IBS. Please include pharmacotherapeutic information.

Using APA 6th ed. Work must be supported by peer-reviewed article published within 5 years. 

“Bariatric Info Session: Tuesday at 7:00 PM.” Gabby looked at the flyer in her physician’s waiting room, wondering if this would be the week that she would muster the courage to get more information about gastric bypass surgery.  Her doctor had been telling her for two years that her elevated BMI, combined with the fact that she had type 2 diabetes, would qualify her for insurance coverage if she decided to have the operation.  But surgery seemed so drastic and irreversible.  She had recently been motivated by a TV feature about a local woman’s weight-loss success story but then her coworker Tim told her that his cousin gained all of his weight back just a few years post-op.

Gabby felt ashamed that she hand’t been able to lose much weight on her own through diet and exercise, despite having worked with a personal trainer and registered dietitian.  Her doctor had told her that part of the bariatric evaluation consisted of meeting with a psychologist to make sure that she would be a good candidate for surgery.  She didn’t like the idea of talking to someone about her feelings, especially regarding the complicated role that food had always played in her life.  And what about the strict diet she would have to follow in the weeks post-surgery-and the changes in eating habits she would need to maintain for the rest of her life?  Gabby had already failed at so many diets that she didn’t know if she would have the willpower necessary to succeed.  And yet her weight was a constant source of worry when she thought about her future. 

Please answer the following questions in your discussion post:

1) If her weight wasn’t causing any health problems currently, should she still consider surgery?

2) Why must patients follow a very strict diet post-bariatric surgery?

3) What are some of the dangers or potential side effects of bariatric surgery?