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Pivot Concepts:
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Target Concepts:
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Query: UMLS:C0022104 (
irritable bowel syndrome
)
8,033
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
Despite multiple invasive diagnostic procedures including exploratory laparotomy and surgical resection, our patient's diagnosis remained an
enigma
. However, given the clinical scenario and the documented PG, a trial of steroids was warranted. The patient has fared well since her treatment, with resolution of all her symptoms. We feel confident that her disease process is most consistent with, and is most likely, Crohn's disease. There are several lessons to be learned from this case: 1) Inflammatory bowel disease can present at any age and belongs in a clinician's differential diagnosis of fever and diarrhea. 2) Failure to consider
IBD
in an elderly patient may lead to significant delay in diagnosis, and may expose the patient to unnecessary and sometimes dangerous intervention. 3)
IBD
in the elderly generally follows the same clinical patterns seen in younger patients. 4) Appropriate therapy can lead to prompt control or even resolution of the signs and symptoms of
IBD
.
...
PMID:Atypical presentation of inflammatory bowel disease in the elderly. 824 80
Postinfective
irritable bowel syndrome
with diarrhoea and idiopathic bile acid malabsorption remains an
enigma
. We examined the records of 84 patients whose 75SeHCAT scans were indicative of bile acid malabsorption (< 15% one week retention). Identifiable causes of bile acid malabsorption were: previous ileal surgery (7), Crohn's disease (22), radiation enteritis (13), vagotomy, gastrectomy or cholecystectomy (10) and miscellaneous (3). Sixteen of 29 patients with apparently idiopathic bile acid malabsorption gave a clear history of acute gastroenteritis before the onset of chronic diarrhoea lasting from 0.25-18 years until their positive 75SeHCAT scan. Only four cases of campylobacter, and one each of shigella and salmonella were documented. Extensive investigation failed to detect other possible pathologies. In response to bile acid sequestrants, mean stool frequency fell from 7.2 per day to 2.1 per day (p < 0.001). We have observed that postinfective chronic diarrhoea is associated with chronic bile acid malabsorption, which can be successfully treated with bile acid sequestrants such as cholestyramine.
...
PMID:Postinfective diarrhoea and bile acid malabsorption. 1133 65