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Irritable Bowel Syndrome

Dr. Helena Fabiani

Asisten Dosen Bagian Ilmu Penyakit Dalam


Fakultas Kedokteran Universitas Kristen Krida Wacana

IBS affects about 10-20% of


the most common disorders

the general population and is one of

seen by primary care physicians.

-The International Foundation for Functional Gastrointestinal Disorders

Pendahuluan
Irritable bowel syndrome (IBS) adalah salah satu penyakit gastrointestinal fungsional yang ditandai oleh adanya nyeri perut, distensi dan gangguan pola defekasi tanpa gangguan organik
The U.S. Food and Drug Administration (2001) melaporkan 20% dari penduduk Amerika mengalami IBS Prevalensi IBS lebih banyak terjadi pada usia dewasa muda dan lanjut, perempuan dua kali lebih banyak daripada laki-laki IBS menghabiskan biaya kesehatan sebesar 8 juta $ US setiap tahunnya

Etiologi
Penelitian Brain-gut response to stress and cholinergic stimulation in IBS dipublikasikan oleh the Journal of Clinical Gastroenterology (1993)

Gejala yg sering didapat pada penderita IBS yaitu : - Feses cair pada saat nyeri - Frekuensi BAB bertambah pada saat nyeri - Nyeri berkurang setelah BAB - Tampak distensi abdomen

Dua gejala tambahan yang sering muncul pada pasien IBS : - Lendir saat BAB - Perasaan tidak lampias saat BAB

Recurrent abdominal pain or discomfort** at least 3 days/month in the last 3 months associated with two or more of the following: . Improvement with defecation . Onset associated with a change in frequency of stool

Onset associated with a change in form (appearance) of stool


* Criterion fulfilled for the last 3 months with symptom onset at least 6 months prior to diagnosis ** Discomfort means an uncomfortable sensation not described as pain. In pathophysiology research and clinical trials, a pain/discomfort frequency of at least 2 days a week during screening evaluation is recommended for subject eligibility.
Rome III criteria diagnostic for functional gastrointestinal disorder

IBS PREDOMINAN DIARE

IBS PREDOMINAN KONSTIPASI

IBS ALTERNATING PATTERN

Diferensial Diagnosis
Sign or symptoms
Alarm factors, Anemia
Chronic severe diarrhea Family history of colon cancer Hematochezia, melena, or other signs of intestinal bleeding Recurrent fever Weight loss Travel to areas with parasitic diseases

Suggested diagnosis
Cancer, IBD
Cancer, infection, IBD Cancer Cancer, arteriovenous malformation, colonic polyps, IBD Infection, IBD Cancer, IBD Infection

Family history of colon cancer, irritable bowel syndrome, celiac disease


Signs or symptoms of malabsorption Nighttime symptoms (e.g., encopresis)

Cancer, celiac disease

Celiac disease Infection, trauma

Onset after 50 years of age

Cancer

Tatalaksana
Diet
Psikoterapi Medikamentosa

IBS Is Not Life Threatening

Points to Remember
IBS is a disorder that interferes with the normal functions of the colon. The symptoms are crampy abdominal pain, bloating, constipation, and diarrhea. IBS is a common disorder found more often in women than men. People with IBS have colons that are more sensitive and reactive to things that might not bother other people, such as stress, large meals, gas, medicines, certain foods, caffeine, or alcohol. IBS is diagnosed by its signs and symptoms and by the absence of other diseases. Most people can control their symptoms by taking medicines such as laxatives, antidiarrhea medicines, antispasmodics, or antidepressants; reducing stress; and changing their diet. IBS does not harm the intestines and does not lead to cancer. It is not related to Crohn's disease or ulcerative colitis.

IBS by National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)