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    Zienab Halem Faculty of Pharmacy SCU

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    Ziad Ahmed
    This document provides information on irritable bowel syndrome (IBS), gallstones, and hemorrhoids. IBS is a functional GI disorder that causes abdominal pain and changes in bowel habits. It does not increase cancer risk. Gallstones form in the gallbladder and can cause biliary colic. Hemorrhoids are swollen blood vessels in the lower rectum that can cause bleeding and pain, especially during bowel movements. Lifestyle changes and topical treatments are recommended for hemorrhoid management.

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    Zienab Halem Faculty of Pharmacy SCU

    Uploaded by

    Ziad Ahmed
    33 views25 pages
    This document provides information on irritable bowel syndrome (IBS), gallstones, and hemorrhoids. IBS is a functional GI disorder that causes abdominal pain and changes in bowel habits. It does not increase cancer risk. Gallstones form in the gallbladder and can cause biliary colic. Hemorrhoids are swollen blood vessels in the lower rectum that can cause bleeding and pain, especially during bowel movements. Lifestyle changes and topical treatments are recommended for hemorrhoid management.

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    This document provides information on irritable bowel syndrome (IBS), gallstones, and hemorrhoids. IBS is a functional GI disorder that causes abdominal pain and changes in bowel habits. It does not increase cancer risk. Gallstones form in the gallbladder and can cause biliary colic. Hemorrhoids are swollen blood vessels in the lower rectum that can cause bleeding and pain, especially during bowel movements. Lifestyle changes and topical treatments are recommended for hemorrhoid management.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    33 views25 pages

    Zienab Halem Faculty of Pharmacy SCU

    Uploaded by

    Ziad Ahmed
    This document provides information on irritable bowel syndrome (IBS), gallstones, and hemorrhoids. IBS is a functional GI disorder that causes abdominal pain and changes in bowel habits. It does not increase cancer risk. Gallstones form in the gallbladder and can cause biliary colic. Hemorrhoids are swollen blood vessels in the lower rectum that can cause bleeding and pain, especially during bowel movements. Lifestyle changes and topical treatments are recommended for hemorrhoid management.

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    of 25

    GIT 3

    Zienab Halem
    Faculty of pharmacy SCU
    8 – IBS
    irritable bowel syndrome

     Functional ( not structure ) GI disorder .


     Common , long term condition affects large intestine ( colon ) .
     More common in women and patients younger than 50 years .
     IBS causes cramping , abdominal pain , bloating , gas , diarrhea and
    / or constipation .
     IBS dosen’t cause changes in bowel tissue or increase risk of
    colorectal cancer .
     Inflammatorybowel disease ( IBD )
    And inflammatory bowel syndrome (
    IBS )
     IBS divided into :

     Diarrhea predominant ( IBS – D )


     Constipation predominant ( IBS – C )
     Mixed IBS ( IBS – M ) or alternating IBS ( IBS – A )
     Screening for celiac disease in patients with IBS-D
    and IBS-M .

     Guidelines recommended :
    If other GI diseases are excluded and no alarm
    symptoms ( e.g weight loss , bleeding and anemia )
    are present , diagnosis of IBS can be made with
    confidence .
     Treatment :

    A – Dietary modifications :
    - Avoid foods that trigger symptoms .
    - Fibers supplementation : may improve symptoms of
    constipation & diarrhea .
     B – pharmacological therapy .

     Antispasmodics :
     Dicyclomine ( Spasmorest )
     Clidinium ( librax ) anxiolytics
     Hyoscine N-butylbromide ( buscopan )
     Peppermint oil ( not for GERD )

     All used for IBS-D and NOT for IBS-C


     Mebeverine
    Without anticholinergic side effect ( relieves painful
    muscle spasms of the gut , without affecting its
    normal motility ) can be used in IBS-C
    1 tab / 3 times daily 20 min. before meals
     Pinaverium
    1 tab / 3 times daily with food
    9 – gall stones ( cholelithiasis )
     Are stones formed within the gall bladder , about 80 % of patients
    are asymptomatic .
     Gall bladder stores and concentrates bile and cholesterol is soluble
    in bile .
     Function :
     1- bile acids help for digestion & absorption of fats and fat-soluble
    vitamin in the small intestine .
     2- many waste products including bilirubin are eliminated from the
    body by secretion into bile & elimination in feces .
     Common symptoms :
    Biliary colic ( crampy pain “right upper abdominal pain ,
    usually after heavy meals and lasts 1 – 4 hrs “ )
    More than 5 hrs : complication .

    Complications signs : Biliary colic more than 5 hrs ,


    fever , persistent tachycardia , hypotension , jaundice .
     Medication :

    Ursodeoxycholic acid
    Reduces cholestasis , prevents formation and promotes
    dissolution of cholesterol – containing gallstones .

    Pregnancy : category B
    Maintenance dose : 250 mg for 6 months
     Rowachol
    Contains essential oils that may help to dissolve or
    break up cholesterol – based gallstones .
    10 – hemorrhoids ( piles )

     Swollen blood vessels in the lower rectum .


     Pregnancy is associated with an increased risk for
    hemorrhoids and there is a slightly increased prevalence
    in women compared with men .
     Chronic constipation has been linked to hemorrhoids .
     Types “
     Internal hemorrhoids : located inside the rectum .
     External hemorrhoids : develop under the skin around the anus

    Signs and symptoms :


    External : very painful , resolves in 2 – 3 days …. Swelling may take a few
    weeks to disappear …. Irritation around the anus .
    Internal :bleeding during bowel movement , painful , irritation and fecal
    incontinence
     Factors increased pressure ::

    - Straining during bowel movements .


    - Chronic diarrhea or constipation .
    - Sitting for long periods on the toilet .
    - Obesity , pregnancy
    - Low fiber intake .
     Management :
     Life style :

    1 – topical treatment .
    2 – sitz bath ( soaking anal area in plain warm water 10 – 15 min 2 – 3
    times daily with potassium permanganate
    3 – keep the anal area clean ( avoid soap , avoid alcohol based wipes )
    4 – don’t use dry toilet paper
    5 – apply cold
    6 – take oral pain relieves .
     Medications :

     1 – topical or suppository corticosteroids : relieve inflammation


    and itching not more than 2 weeks .
     2 – topical zinc oxide , petroleum jelly , cocoa butter , hard fat
    , mineral oil or shark liver oil : reduce itching .
     3 – topical local anesthetic : for who have painful external
    hemorrhoids .
     4 – oral venoactive drug : daflon .
     5 – oral NSAIDs : not more than 1 week .
     Daflon
    500 mg ( 1 tab ) / 4 hours for first 4 days
    500 mg / 6 hours for 3 days
    500 mg / twice for 3 months

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