My Part

Irritable Bowel Syndrome
Irritable bowel syndrome has been called spastic colon, functional bowel disease, and mucous colitis. However, IBS is not a true "colitis." The term colitis refers to a separate condition known as inflammatory bowel disease (IBD).
Irritable bowel syndrome (IBS or spastic colon) is a diagnosis of exclusion. It is a functional bowel disorder characterized by chronic abdominal pain, discomfort, bloating, and alteration of bowel habits in the absence of any detectable organic cause. Diarrhea or constipation may predominate, or they may alternate (classified as IBS-D, IBS-C or IBS-A, respectively). IBS may begin after an infection (post-infectious, IBS-PI), a stressful life event, or onset of maturity without any other medical indicators.
Irritable bowel syndrome is not contagious, inherited, or cancerous.
Fortunately, unlike more-serious intestinal diseases such as ulcerative colitis and Crohn's disease, irritable bowel syndrome doesn't cause inflammation or changes in bowel tissue or increase your risk of colorectal cancer. However, IBS often disrupts daily living activities.
IBS is considered a functional disorder in that diagnostic testing does not show any visible disease process. To determine whether a person is just having temporary digestive distress or if he does have IBS, doctors use a standard called the Rome III criteria. According to these criteria, IBS can only be diagnosed if symptoms have been present for at least six months. Symptoms must have been experienced on at least three days of at least three months. Specifically, symptoms must consist of recurrent abdominal pain or discomfort with two or more of the following:
• Pain is relieved by a bowel movement
• Onset of pain is related to a change in frequency of stool
• Onset of pain is related to a change in the appearance of stool
Symptoms
The signs and symptoms of irritable bowel syndrome can vary widely from person to person and often resemble those of other diseases. Among the most common are:
• Abdominal pain or cramping
• A bloated feeling
• Gas (flatulence)
• Diarrhea or constipation — sometimes alternating bouts of constipation and diarrhea
• Mucus in the stool
Red-flag IBS Symptoms
IBS symptoms can be so severe and disruptive that sufferers frequently worry about misdiagnosis and that their doctor has overlooked a more serious disorder. The following list describes symptoms that are NOT typical of IBS and would warrant further investigation:
• fever
• vomiting
• blood in the stool (may be only from hemorrhoids, but MUST be brought to the attention of a qualified physician)
• significant and unexplained weight loss
• anemia
• abdominal pain and cramping not relieved by a bowel movement
• abdominal pain and cramping which awakes the sufferer from sleep
• poor appetite (not caused by a fear of eating trigger foods)
• fatigue
Epidemiology
IBS affects 10% to 15% of the US population. However, published prevalence rates are likely underestimates because only 25% to 30% of patients with IBS symptoms seek medical attention, probably because of fear, embarrassment, mild symptoms, or the misperception that no effective treatments are available. This is illustrated in a study by Mearin and colleagues,[8] who found that IBS symptoms were unstable over time, with the greatest instability among those with irritable bowel syndrome with constipation (IBS-C) and IBS-diarrhea (D) subtypes; only 46% and 51% remained in the same subgroup during the study, with the remaining switching to the IBS-A subtype. Although there may be a consistent number of people with a certain subtype overall, there is continual movement of patients from one subtype to another; an exception is IBS-C to IBS-D and visa versa, which is rare.
Although IBS affects men and women, a woman-to-man ratio of 2:1 exists in the United States. The gap widens considerably in tertiary care settings, with women outnumbering men by 3:1. Most people seeking medical attention for IBS symptoms for the first time are 30-50 years old. The prevalence of IBS declines after age 60. In fact, the onset of IBS after age 40 is unusual, unless it is caused by infection, medication, trauma, or cholecystectomy.
Nineteen percent of respondents in a survey of married or cohabiting people with IBS stated that they had difficulties in their personal relationships, and 45% stated that IBS interfered with their sex life.
Like many people, you may have only mild signs and symptoms of irritable bowel syndrome. However, sometimes these problems can be disabling. In some cases, you may have severe signs and symptoms that don't respond well to medical treatment. Because symptoms of irritable bowel syndrome can occur with other diseases, it's best to discuss these symptoms with your doctor.
For most people, IBS is a chronic condition, although there will likely be times when the signs and symptoms are worse and times when they improve or even disappear completely.


DIFFERENTIAL DIAGNOSIS OF Iron Deficency Anemia
IDA is classically described as a microcytic anemia. The differential diagnosis for microcytic anemia includes iron deficiency, thalassemia, sideroblastic anemias, some types of anemia of chronic disease, and lead poisoning (rare in adults). Patients with sideroblastic anemia will have almost complete saturation of the serum transfer-rin, which can differentiate them from patients with iron deficiency. Differentiating between iron deficiency and anemia of chronic disease can sometimes be difficult, especially in early iron deficiency or when the conditions coexist. Patients with lead poisoning will have characteristic signs and symptoms of lead poisoning.