Novosti
|
This journal is indexed in Scopus |
|---|
Year 2012 Vol. 20 No 5
PRACTICAL CASES
M.D.LEVIN, Z.KORSHUN, G.MENDELSON
RARE CASE OF SURGICAL TREATMENT OF THE IRRITABLE BOWEL SYNDROME
State Geriatric Center, Netanya, Israel
We present the case of the severe irritable bowel syndrome in a 76 year old woman. Chronic constipation and abdominal pain grew with time, and there was no relief in response to medication, diet, and psychotherapy. Severe spasm of the left part of the colon was found on barium enema. Laxatives didn’t help, and most of them even increased the severity of pain. Some relieve appeared only after a bowel movement after an enema. The procedure of purgation has taken up to 5 hours recently; and if there was no any effect the patient had to call for emergent hospital aid. The patient has lost 18 kg due to constrained dietary restriction. Quality of life has dramatically improved after the colostomy of the right transverse colon. The intensity and frequency of the pain syndrome decreased significantly. During the first 6 months after the surgery the patient regained 3 kg.
The described observation shows appropriateness of the surgical treatment in cases of severe irritable bowel syndrome which can’t be treated by means of conservative therapy. To solve the problem of the place of fecal fistula application, X-ray examination with the contrast substance is advisable to plan the operation proximal to the spastic site.
1. Everitt HA, Moss-Morris RE, Sibelli A, Tapp L, Coleman NS, Yardley L, Smith PW, Little PS. Management of irritable bowel syndrome in primary care: feasibility randomised controlled trial of mebeverine, methylcellulose, placebo and a patient self-management cognitive behavioural therapy website. (MIBS trial). BMC Gastroenterol. 2010 Nov 18;10:136.
2. Ron Y. Irritable bowel syndrome: epidemiology and diagnosis. Isr Med Assoc J. 2003 Mar;5(3):201–2.
3. Engsbro AL, Simren M, Bytzer P. The Rome II and Rome III criteria identify the same subtype-populations in irritable bowel syndrome: agreement depends on the method used for symptom report. Neurogastroenterol Motil. 2012 Jul;24(7):604–e266. doi: 10.1111/j.1365-2982.2012.01908.x.
4. Ishihara S, Yashima K, Kushiyama Y, Izumi A, Kawashima K, Fujishiro H, Kojo H, Komazawa Y, Hamamoto T, Yamamoto T, Sasaki Y, Shimizu T, Okamoto E, Yoshimura T, Furuta K, Noguchi N, Tanaka H, Murawaki Y, Kinoshita Y. Prevalence of organic colonic lesions in patients meeting Rome III criteria for diagnosis of IBS: a prospective multi-center study utilizing colonoscopy. J Gastroenterol. 2012 Mar 30. [Epub ahead of print]
5. Ritchie J. Pain from distension of the pelvic colon by inflating a balloon in the irritable colon syndrome. Gut. 1973 Feb;14(2):125–32.
6. O'Connor OJ, McSweeney SE, McWilliams S, O'Neill S, Shanahan F, Quigley EM, Maher MM. Role of radiologic imaging in irritable bowel syndrome: evidence-based review. Radiology. 2012 Feb;262(2):485–94.
7. Jailwala J, Imperiale TF, Kroenke K. Pharmacologic treatment of the irritable bowel syndrome: a systematic review of randomized, controlled trials. Ann Intern Med. 2000 Jul 18;133(2):136–47.
8. Olden KW. Irritable bowel syndrome: an overview of diagnosis and pharmacologic treatment. Cleve Clin J Med. 2003 Jun;70(Suppl. 2):S3–7.
9. Ducrotte P. Irritable bowel syndrome: from the gut to the brain-gut. Gastroenterol Clin Biol. 2009 Aug-Sep;33(8-9):703–12. [Article in French]
10. Shafik A, Shafik AA, Ahmed I, el-Sibai O. Treatment of irritable bowel syndrome with colonic pacing: evaluation of pacing parameters required for correction of the "tachyarrhythmia" of the IBS. Hepatogastroenterology. 2004 Nov-Dec;51(60):1708–12.
11. Gasiorowska A, Poh CH, Fass R. Gastroesophageal reflux disease (GERD) and irritable bowel syndrome (IBS)–is it one disease or an overlap of two disorders? Dig Dis Sci. 2009 Sep;54(9):1829–34.
12. Nastaskin I, Mehdikhani E, Conklin J, Park S, Pimentel M. Studying the overlap between IBS and GERD: a systematic review of the literature. Dig Dis Sci. 2006 Dec;51(12):2113–20.
13. Sjodahl R, Schulz C, Myrelid P, Andersson P. Long-term quality of life in patients with permanent sigmoid colostomy. Colorectal Dis. 2012 Jun;14(6):e335-8. doi: 10.1111j.1463-1318.2012.02941.x.
14. Kald A, Juul KN, Hjortsvang H, Sjodahl RI. Quality of life is impaired in patients with peristomal bulging of a sigmoid colostomy. Scand J Gastroenterol. 2008;43(5):627–33.
42202, Israel, Natanya Amnin ve-Tamar, 1/2, State Geriatric Center,
e-mail: nivel70@hotmail.com
Levin Michael Davidovich
Levin M.D. MD, Radiologist of State Geriatric Center of Netanya
Korshun Z. Head of the Geriatric Department of State Geriatric Center of Netanya
Mendelson G. Head of the Geriatric Department, Head Doctor of the Hospital of State Geriatric Center of Netanya
Article in the .pdf format
