Nursing management of irritable bowel syndrome treatment options

Nursing Care of Patients with Gastrointestinal Alterations.

This article is about the challenges faced by those who suffer from irritable bowel syndrome (IBS). The symptoms generally include abdominal pain that connects with issues such as a change in bowel problems. After a full description of the condition and its associated symptoms, the authors consider treatment. Although IBS is the most common of gastrointestinal disorders, no single treatment exists to alleviate it with complete effectiveness. For this reason, there are many treatment options that a sufferer may integrate to find relief from the condition. In addition to various lifestyle changes a person can make, the authors also consider medications and non-medicinal therapies such as psychological and alternative treatments.

By reading this article, I learned that there are many different physical symptoms that occur under the category of IBS. Concomitantly, there are many different pharmaceutical therapies available to treat these symptoms. For constipation, for example, laxatives are generally prescribed. Diarrhea, on the other hand, is relieved by GI transit delay agents. Those who experience neither diarrhea nor constipation in significant amounts but do suffer from abdominal pain and discomfort can benefit from antispasmodic agents. Although I was aware that sufferers do have a number of different symptoms, I did not realize that these could be so widely different for different people.

I also learned that patients can benefit from simple changes in lifestyle and diet. One of the most common lifestyle exacerbators of IBS is, for example, stress. A very common prescription in terms of lifestyle is to engage in therapies that reduce stress, such as meditation or exercise. Regular exercise can also improve bowel function, which may reduce the discomfort and other symptoms patients experience. The authors note that patients tend to have more confidence in the efficacy of exercise and lifestyle changes than in pharmaceutical therapies. This was surprising to me, since I have always had the conception that patients would be more confident in a prescription of drugs than in simple changes that they can manage themselves.

In terms of dietary changes, the authors report that foods like dairy products, serial, caffeine, alcohol, and certain artificial sweeteners can exacerbate symptoms. Foods that are rich in fermentable carbohydrates exacerbate symptoms. The nurse's role in this is to identify which foods patients are most sensitive to and help them to eliminate these from their diet.

The most interesting information in the article relates to the non-pharmaceutical and alternative interventions and therapies. Psychological therapies, for example, include cognitive-behavioral therapy (CBT), where the aim is to address the cognitive aspect of the psychological symptoms experienced by the individual. In other words, where stress is a significant exacerbator of IBS, the therapy would focus on the various elements of stress that the individual is aware of. CBT can be administered in either group or individual therapy. A second type of psychological intervention is gut-directed hypnotherapy. In this, the authors note that the therapist uses interventions such as progressive relaxation and imagery to relieve IBS symptoms by directing the techniques towards the gut. Although limited, existing data show that this therapy has been effective in reducing symptoms and improving quality of life.

Complementary and alternative therapies have also caught my attention. In addition to substances such as probiotics and peppermint oil, acupuncture and mind-body practices are also suggested for the relief of IBS. According to the authors, these therapies stimulate physical processes that promote healing and regularity within the bowels.

Finally, another thing I have learned from the article is that, often, patients with IBS feel either misunderstood or dismissed by health care providers. This is one of the most surprising aspects of the article for me. As a health care provider myself, it is my aim to be as accessible to the patient as possible, regardless of the condition he or she suffers from. Hence, I believe all clinicians and therapists need to take more care to be accessible and open towards their patients. Patients with IBS, just like all other patients, need empathy. Like all patients, those with IBS deserve to be heard and receive the best quality of care that is available. Certainly, with all the therapies that have been listed as available, a nursing professional should be able to help such a person come to terms with and manage his or her condition.

The information in the article is therefore extremely helpful to me as a student in the clinical area. The most important thing I have learned, I feel, is the way in which patients tend to feel dismissed or misunderstood. My work as clinical nurse will therefore be to make IBS patients as comfortable as possible to share whatever symptoms they are experiencing. Like the example of "Ms Cooley" mentioned in the article, I will start the therapeutic process by talking to the patient and listening to any concerns he or she has, along with the patient's conception of factors that exacerbate the condition. Based on this article, I can then use this information to create an effective and integrated treatment plan for the patient.