APA Style 2 References 5 Years Minimum Jordan Is A 35-Year-O

Apa Style 2 References 5 Years Minimumjordan Is A 35 Year Old Woman

APA Style. 2 references 5 years minimum. Jordan is a 35-year-old woman who presents with intermittent diarrhea with cramping that is relieved by defecation. The diarrhea is not bloody or accompanied by nausea and vomiting. Review of past medical history includes some childhood “stomach issues”, hypertension, and a recent cholecystectomy. She works in the environmental department of a large hotel. She denies alcohol and cigarettes. Diagnosis: Irritable Bowel Syndrome (IBS).

Discuss the epidemiology of IBS.

What are your treatment goals for this patient?

Discuss first-line and second-line drug therapy for IBS, including pharmacotherapeutic information.

Paper For Above instruction

Introduction

Irritable Bowel Syndrome (IBS) is a common functional gastrointestinal disorder characterized by a group of symptoms that typically include abdominal pain, bloating, and altered bowel habits such as diarrhea and constipation. It is one of the most prevalent gastrointestinal disorders worldwide, significantly impacting patients' quality of life and imposing economic burdens on healthcare systems. Understanding the epidemiology of IBS is essential for developing effective management strategies for affected individuals like Jordan.

Epidemiology of IBS

IBS affects approximately 10-15% of the global population, with variations depending on the geographic location, diagnostic criteria, and study methodologies (Lovell & Ford, 2018). It is more commonly diagnosed in women, with a female-to-male ratio of approximately 2:1 in clinical settings, which aligns with Jordan's demographic profile (Chang et al., 2020). The onset of IBS usually occurs in early adulthood, but it can affect individuals of any age, including children and the elderly.

The etiology of IBS is multifactorial, involving genetic predisposition, altered gastrointestinal motility, visceral hypersensitivity, gut-brain axis dysfunction, and psychosocial factors such as stress and anxiety. Studies have also identified environmental influences, including diet and lifestyle, as contributing to the manifestation and severity of symptoms (Simren et al., 2018). The presence of comorbidities like hypertension and previous abdominal surgeries, as in Jordan’s case, can influence the presentation and management of IBS.

Management Goals for Jordans

The primary goals in managing Jordan’s IBS include alleviating her symptoms—particularly diarrhea and cramping—improving her quality of life, and preventing symptom escalation. Since her diarrhea is intermittent and relieved by defecation, treatment should aim to reduce bowel irregularities and abdominal discomfort. Additionally, given her work environment and medical history, it is vital to consider non-pharmacological factors such as diet modifications, stress management, and addressing her previous gastrointestinal issues.

Pharmacotherapy for IBS: First-line and Second-line

First-line therapy for IBS depends on the predominant symptom pattern, with dietary modifications being central to initial management. For diarrhea-predominant IBS (IBS-D), dietary modifications such as increased soluble fiber intake and avoidance of trigger foods are recommended. Pharmacologic agents are considered when symptoms are moderate to severe or unresponsive to lifestyle interventions. The first-line pharmacologic treatments for IBS-D include antispasmodics and antidiarrheals.

Antispasmodics, such as hyoscine butylberrate or dicyclomine, are used to relieve cramping by relaxing smooth muscles in the gastrointestinal tract. Loperamide, an opioid receptor agonist, is frequently used to control diarrhea by reducing intestinal motility (Lacy et al., 2020). Both medications have demonstrated efficacy in symptom relief, with minimal systemic absorption and favorable safety profiles. However, they do not address abdominal pain or bloating, underscoring the importance of a holistic management approach.

Second-line therapies include adding agents like probiotics, for modifying gut flora, and antidepressants such as tricyclic antidepressants or selective serotonin reuptake inhibitors (SSRIs) to address visceral hypersensitivity and the psychosocial aspects of IBS (Ford et al., 2018). Specifically, low-dose tricyclic antidepressants like amitriptyline have been shown to reduce pain and improve bowel habits in IBS patients, especially when pain dominates symptomatology (Sperber et al., 2020). These medications also help modulate gut-brain axis dysfunction, which plays a role in IBS pathogenesis.

In recent years, newer pharmacological options have emerged, including guanylate cyclase-C agonists and 5-HT3 receptor antagonists, but their use is more targeted and often reserved for specific cases or refractory symptoms. It is crucial to tailor pharmacotherapy to individual patient profiles, considering comorbidities, potential side effects, and patient preferences.

Conclusion

IBS remains a complex disorder with a multifactorial etiology, affecting a significant portion of the population, especially women like Jordan. Effective management involves comprehensive assessment, symptom-specific treatment goals, and a combination of lifestyle modifications and pharmacotherapy. First-line treatments focus on symptom relief and dietary adjustments, while second-line therapies include medications aimed at tackling the underlying visceral hypersensitivity and gut motility issues. Personalized treatment plans are essential for improving outcomes and enhancing quality of life for IBS patients, emphasizing the need for continued research and clinical vigilance.

References

• Chang, L., Talley, N. J., & Ford, A. C. (2020). Epidemiology and pathophysiology of irritable bowel syndrome: An update. Gastroenterology, 159(3), 717–733.
• Ford, A. C., Lacy, B. E., Talley, N. J., et al. (2018). Functional bowel disorders. Gastroenterology, 150(6), 1393–1407.
• Lacy, B. E., Mearin, F., Chang, L., et al. (2020). Bowel Disorders. Gastroenterology, 158(1), 46–54.e2.
• Lovell, R. M., & Ford, A. C. (2018). Global prevalence of and risk factors for irritable bowel syndrome: a meta-analysis. Clinical Gastroenterology and Hepatology, 16(6), 876–886.
• Simren, M., Barbara, G., Bercik, P., et al. (2018). Intestinal microbiota in functional bowel disorders: A Rome IV perspective. Gut, 67(1), 159–176.
• Sperber, A. D., Bang, C., & Frankel, O. (2020). Caring for patients with irritable bowel syndrome. Nature Reviews Gastroenterology & Hepatology, 17(6), 371–376.