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Constipation: A Practical Approach to Diagnosis and Treatment serves as an unmet resource for physicians and other health care providers, including trainees and students, who see patients with constipation. The text reviews pathophysiologic mechanisms and details evaluation and management strategies. The volume also enables the reader to identify epidemiologic factors and quality of life parameters for patients with constipation, discuss differences in pathophysiologic mechanisms for different etiologies of constipation, recognize primary causes of constipation, and assess special considerations related to the symptom of constipation including presentations in the elderly, in pregnant women, in patients with systemic diseases, and patients with a history of abuse. Written by thought leaders and recognized experts in gastrointestinal motility and medical education, Constipation: A Practical Approach to Diagnosis and Treatment is of great value and utility for gastroenterologists, primary care physicians, gynecologists, nurse practitioners, physician’s assistants, as well as fellows and residents.
Three distinct types of contractions perform colonic motility functions. Rhythmic phasic contractions (RPCs) cause slow net distal propulsion with extensive mixing/turning over. Infrequently occurring giant migrating contractions (GMCs) produce mass movements. Tonic contractions aid RPCs in their motor function. The spatiotemporal patterns of these contractions differ markedly. The amplitude and distance of propagation of a GMC are several-fold larger than those of an RPC. The enteric neurons and smooth muscle cells are the core regulators of all three types of contractions. The regulation of contractions by these mechanisms is modifiable by extrinsic factors: CNS, autonomic neurons, hormones, inflammatory mediators, and stress mediators. Only the GMCs produce descending inhibition, which accommodates the large bolus being propelled without increasing muscle tone. The strong compression of the colon wall generates afferent signals that are below nociceptive threshold in healthy subjects. However, these signals become nociceptive; if the amplitudes of GMCs increase, afferent nerves become hypersensitive, or descending inhibition is impaired. The GMCs also provide the force for rapid propulsion of feces and descending inhibition to relax the internal anal sphincter during defecation. The dysregulation of GMCs is a major factor in colonic motility disorders: irritable bowel syndrome (IBS), inflammatory bowel disease (IBD), and diverticular disease (DD). Frequent mass movements by GMCs cause diarrhea in diarrhea predominant IBS, IBD, and DD, while a decrease in the frequency of GMCs causes constipation. The GMCs generate the afferent signals for intermittent short-lived episodes of abdominal cramping in these disorders. Epigenetic dysregulation due to adverse events in early life is one of the major factors in generating the symptoms of IBS in adulthood.
An easy-to-follow plan to regain a healthy gastrointestinal system-and relieve problems from gas to bloating to IBS. Close to 100 million Americans suffer from chronic-and sometimes very serious- gastrointestinal conditions. Prominent gastroenterologist Dr. Wesley Jones has found that virtually all digestive problems have one single underlying cause-constipation. Our modern diets and stressful lifestyles can make poor digestion such a common experience that sometimes people don't even recognize it as a problem. Here, Dr. Jones provides a proven program that has already helped thousands relieve and prevent constipation-related gastrointestinal problems for life. No one wants to talk about constipation, but millions suffer from it. Take as evidence the ubiquitous ads for Dannon's billion-dollar brand, Activia, which features Jamie Lee Curtis talking about "occasional irregularity." Constipation is one of the most common gastrointestinal complaints in the United States, resulting in about two million doctor visits annually. However, most people treat themselves without seeking medical help, as is evident from the millions of dollars Americans spend on laxatives each year. Now, this book will offer them a safe, proven, easy-to-follow program to relieve constipation once and for all. Because it's not just uncomfortable-it's unhealthy!
This open access book takes a multidisciplinary approach to provide a holistic understanding of late old age, and situates the aged person within the context of family, caregivers, clinical and other institutions. All through the book, the author discusses preparedness for an aging individual as well as the society in the Indian context. The book highlights inevitable but mostly neglected health issues like depression, dementia, fall, and frailty and provides detailed analyses of solutions that are practicable in low resource settings. It also brings up intergenerational differences and harmony in the context of holistic care of older Indians. Alongside clinical perspectives, the book uses narratives of elderly patients to dwell on the myriad of problems and issues that constitute old age healthcare. Demonstrating cases that range from the most influential to the most underprivileged elderly in India, the book enlightens multiple caregivers—doctors, nurses, and professional caregivers as well as family members—about the dynamic approach required in dealing with complex issues related to late old age. The narratives make the book relatable and interesting to non-academic readers, with important lessons for gerontological and geriatric caregiving. It is also of use to older adults in preparing for active aging.
Updated annually with the latest developments in diagnosis and treatment recommendations, Ferri’s Clinical Advisor uses the popular "5 books in 1" format to organize vast amounts of information in a clinically relevant, user-friendly manner. This efficient, intuitive format provides quick access to answers on more than 900 common medical conditions, including diseases and disorders, differential diagnoses, and laboratory tests – all updated by experts in key clinical fields. Updated algorithms and current clinical practice guidelines help you keep pace with the speed of modern medicine. Contains significant updates throughout, with more than 500 new figures, tables, and boxes added to this new edition. Features 17 all-new topics including opioid overdose, obesity-Hypoventilation syndrome, acute pelvic pain in women, new-onset seizures, and eosinophilic esophagitis, among many others. Provides current ICD-10 insurance billing codes to help expedite insurance reimbursements. Includes cross-references, outlines, bullets, tables, boxes, and algorithms to help you navigate a wealth of clinical information. Offers access to exclusive online content: more than 90 additional topics; new algorithms, images, and tables; EBM boxes; patient teaching guides, color images, and more.
A renowned physician shares her complete 10-day digestive tune-up for women, with important revelations about good gastrointestinal health. Many so-called cures for women’s bloating and indigestion, from juice cleanses to specialty diets, are based on junk science. For women seeking true relief from that overall feeling of discomfort in any size jeans, Dr. Robynne Chutkan has the perfect plan for feeling light, tight, and bright in ten days. Gutbliss offers: A primer on the real reasons for gastrointestinal distress, and why it’s much more common in women A look at the debilitating side effects of supposedly healthy habits—from Greek yogurt to bloat-inducing aspirin An expert analysis of symptoms that could indicate a serious underlying condition An indispensable checklist to pinpoint the exact cause of your bloating Just a few small changes in diet, lifestyle, and exercise can make a huge difference in a woman’s digestive health, but the changes have to be the right ones. Going beyond the basics of top sellers such as Wheat Belly, Dr. Chutkan’s Gutbliss empowers women to take control of their gastrointestinal wellness.
The instant New York Times, USA Today, and Publisher's Weekly bestseller A bold new plant-based plan that challenges popular keto and paleo diets, from an award-winning gastroenterologist. The benefits of restrictive diets like paleo and keto have been touted for more than a decade, but as renowned gastroenterologist Dr. Will Bulsiewicz, or "Dr. B," illuminates in this groundbreaking book, the explosion of studies on the microbiome makes it abundantly clear that elimination diets are in fact hazardous to our health. What studies clearly now show--and what Dr. B preaches with his patients--is that gut health is the key to boosting our metabolism, balancing our hormones, and taming the inflammation that causes a host of diseases. And the scientifically proven way to fuel our guts is with dietary fiber from an abundant variety of colorful plants. Forget about the fiber your grandmother used to take--the cutting-edge science on fiber is incredibly exciting. As Dr. B explains, fiber energizes our gut microbes to create powerhouse postbiotics called short-chain fatty acids (SCFAs) that are essential to our health. SCFAs are scientifically proven to promote weight loss, repair leaky gut, strengthen the microbiome, optimize the immune system, reduce food sensitivities, lower cholesterol, reverse type 2 diabetes, improve brain function, and even prevent cancer. Restrictive fad diets starve the gut of the critical fiber we need, weaken the microbes, and make our system vulnerable. As a former junk-food junkie, Dr. B knows firsthand the power of fiber to dramatically transform our health. The good news is that our guts can be trained. Fiber-rich, real foods--with fruits, vegetables, whole grains, seeds, nuts, and legumes--start working quickly and maintain your long-term health, promote weight loss, and allow you to thrive and feel great from the inside out. With a 28-day jumpstart program with menus and more than 65 recipes, along with essential advice on food sensitivities, Fiber Fueled offers the blueprint to start turbocharging your gut for lifelong health today.
Identify and treat digestive problems before they become difficult to manage—with this comprehensive reference from the world-renowned Mayo Clinic. Digestive problems are among the most common reasons people see doctors and take medication. This updated fourth edition of Mayo Clinic on Digestive Health is an authoritative yet practical reference manual that includes information on everything from healthy digestion to cancer treatment. The book is packed with helpful advice on treating common digestive conditions and preventing serious disease, with information on: Belching, bloating and gas • Celiac disease • Colorectal cancer • Constipation and diarrhea • Crohn’s disease and ulcerative colitis • Diverticular disease • Gallbladder disease • Heartburn and GERD • Irritable bowel syndrome • Liver disease • Pancreatic disease • Swallowing difficulties • Ulcers and stomach pain Also covered are diagnostic testing, mealtime recommendations and self-care tips for relieving discomfort, and the latest information on endoscopic ultrasound, virtual colonoscopy, and the newer minimally invasive treatments for gastroesophageal reflux disease (GERD).