1. Kingdom of Saudi Arabia Alghad collages –Tabuk girls

2. Irritable bowel syndrome Supervisor : Dr. Shereen Abd elmonem Prepared By student nurses : Abeer Alghamdi Fadhelah Obaid Haneen Alkhebari Fatimah Alkhebari

3. Out line  Introduction of GIT.  Identifaction of GIT parts AND Function  Definition of irritable bowel syndrome and Classification.  Causes of IBS.  Identification of sing & symptom of IBS.  Description of NURSING diagnoses of IBS.  Complication ( Risk factors ) of IBS.  Knowing the medication can use for treatment of IBS  Summery about IBS.  References of IBS.

4. Objective  At the End of this lecture the students nurse will be learn to :  Identify the GIT parts & function.  Define the IBS and Classified.  Explain the causes of IBS.  Identify the sings & Symptoms of IBS.  Describe the Nursing diagnoses of IBS.  Know of risk factors or Complication of IBS.  List of medication can treat IBS.  Conclusion of IBS.

5. Introduction Osler coined the term mucous colitis in 1892 when he wrote of a disorder of mucorrhea and abdominal colic with a high incidence in patients with coincident psychopathology. that occur in women more than men at 12% - 14 in adult. Since that time, the syndrome has been referred to by sundry terms, including spastic colon, irritable colon, and nervous colon.

6. GIT Gastrointestinal Tract parts and function Parts Of GIT. Mouth Esophagus Stomach Small intestine Large Intestine Rectum Function Of GIT Digestion Absorption & Elimination of Food

7. Mouth Esophagus Stomach Large intestine Small Intestine Rectum

8. Parts Of The Large Intestine Ascending Colon Descending Colon Transvers Colon Sigmoid Colon

9. Definition Irritable Bowel Syndrome (IBS) is a functional GI disorder characterized by abdominal pain and altered bowel habits. OR Irritable Bowel Syndrome (IBS) is a Chronic Functional bowel disorder that effects frequency of defication and consistency of stool.

10. Classification Of IBS IBS can be classified as either diarrhea-predominant (IBS-D). constipation-predominant (IBS-C). or with alternating stool pattern (IBS-A)

11. Pathophysiology of IBS Traditional theories regarding pathophysiology may be visualized as a 3-part complex of altered GI motility, visceral hyperalgesia, and psychopathology. IBS results from functional disorder of intestinal motility.The change in motility may be related To Neuroendocrine dysregulation. Especially change in serotonin signaling Infection, irritation, vascular or metabolic disturbance.

12. Signs & Symptoms The primary symptoms of IBS are : Abdominal pain Altered bowel habits Abdominal distention

13. Abdominal pain in IBS is protean, but may have the following characteristics Pain frequently Common sites of pain include the lower abdomen, specifically the left lower quadrant Acute episodes of sharp pain Meals may precipitate pain Defecation commonly improves pain but may not fully relieve it

14. Altered bowel habits in IBS may have the following characteristics Constipation variably Diarrhea Postprandial urgency is common, as is alternation between constipation and diarrhea

15. Additional symptoms consistent with irritable bowel syndrome are as follows Dyspepsia, heartburn Nausea, vomiting Urinary frequency

16. Factors that affects in IBS (Causes) While the cause of IBS is unknown. There Are various factors associated with the syndrome : # Heredity Anxiety, and depression ( Psycologocal Stress )  Diet High in fat.  consumption of spicy foods is directly associated with IBS.

17. Cont >>> causes of IBS 4# Stimulating or irritating some Food. 5# Smoking 6# Alcohol Consumption

18. Diagnosis of irritable bowel syndrome Family history of certain organic GI illnesses (eg, inflammatory bowel disease, celiac sprue, colorectal cancer A comprehensive history, a physical examination. Abdominal pain Relieved by defecation Onset associated with a change in stool frequency Onset associated with a change in stool form or appearance

19. Weight loss Iron deficiency anemia Family history of certain organic GI illnesses (eg, inflammatory bowel disease, celiac sprue, colorectal cancer) Complete blood count with differential to screen for anemia, inflammation, and infection Stool examinations

20. Screening studies to rule out disorders other than IBS include the following Complete blood count with differential to screen for anemia, inflammation, and infection A comprehensive metabolic panel to evaluate for metabolic disorders dehydration/electrolyte abnormalities in patients with diarrhea Stool examinations for ova and parasites, enteric pathogens, leukocytes, Clostridium difficile toxin, and possibly Giardia antigen

21. Complications Post-infectious Stress Active infections

22. Management Management of irritable bowel syndrome consists primarily of providing psychological support and recommending dietary Diet (Fiber ) Medication Psychological therapies Stress relief

23. Diet Dietary measures may include the following : Fiber supplementation may improve symptoms of constipation and diarrhea  Caffeine avoidance may limit anxiety and symptom exacerbation water intake is recommended in patients who predominantly experience constipation Legume avoidance may decrease abdominal bloating

24. Medications for Treatment of IBS. laxatives in IBS-C antidiarrheals e.g., opiate, opioid(loperamide, codeine )FOR A MILD SYMPTOM morphine and oxycodone Certain antipsychotic medications clozapine and olanzapine antispasmodic drugs (e.g., anticholinergics such as hyoscyamine

26. Summary Irritable bowel syndrome (IBS) is a symptom-based diagnosis. It is characterized by chronic abdominal pain, discomfort, bloating, and alteration of bowel habits. Diarrhea or constipation may predominate, or they may alternate (classified as IBS-D, IBS-C, or IBS-A, respectively).

27. References  Website From Wikipedia, the free encyclopedia.  Book of ‘’ Text Book of Medical-Surgical nursing’’