Bakgrund: Irritable Bowel Syndrome (IBS) och Funktionell Dyspepsi (FD) är två syndrom som många personer lider av och som det inte finns någon botande behandling för. Då syndromen bara går att symptomlindra tar många av personerna som lider av dessa till egenvårdsmetoder som ofta är kostrelaterade. Att stötta och vägleda patienter i sin egenvård är en uppgift som sjuksköterskor i allmänhet har, och i synnerhet för dessa patienter eftersom ingen botande behandling finns. Syfte: Syftet med föreliggande litteraturstudie var att beskriva kostrelaterade egenvårdsmetoder för patienter med Irritable Bowel Syndrome och/eller Funktionell Dyspepsi där upplevda och/eller observerade effekter beskrivits. Syftet var även att beskriva de valda studiernas datainsamlingsmetoder. Metod: En litteraturstudie med beskrivande design. Datainsamlingen har skett från databaserna PubMed och CINAHL. Huvudresultat: Tretton studier har inkluderats. Utifrån dessa har det framkommit att patienter som lider av IBS och/eller FD kan ta till en mängd olika kostrelaterade egenvårdsmetoder. Effekter av dessa har visat sig förebygga och/eller lindra fysiska symptom från mag-tarmkanalen samt i och med detta ge förbättrad livskvalitet. De datainsamlingsmetoder som beskrivits har visat sig variera mellan frågeformulär och skattningsskalor, dagböcker, kroppsliga markörer samt gruppintervjuer. Slutsats: Patienter med IBS och/eller FD kan använda sig av ett flertal olika kostrelaterade egenvårdsmetoder i syfte att förebygga och/eller lindra sina symptom från mag-tarmkanalen. En mängd olika datainsamlingsmetoder kan användas för att identifiera olika kostrelaterade egenvårdsmetoder och dess påverkan på symptom från IBS och/eller FD. / Background: Irritable Bowel Syndrome (IBS) and Functional Dyspepsia (FD) are two syndromes that many people suffers from and that has no curing treatment. Since the syndromes only has a symptomatic treatment many people that suffers from it uses self-care methodes that often includes diet. Support and guidance in patiens self-care are a main task for nurses in general and especially for these patients since no curing treatment is available. Aim: The aim of the present study was to describe dietary self-care practices for patients with Irritable Bowel Syndrome and/or Functional Dyspepsia where the perceived and/or observed effects was described. The aim was also to describe the selected studies data collection methods. Method: A literature review with descriptive design. Data has been collected from the databases PubMed and CINAHL. Main Results: Thirteen studies were included. From these, it has been found that patients suffering from IBS and/or FD may use a variety of dietary self-care methods. Effects of these have been shown to prevent and/or alleviate physical symptoms from the gastrointestinal tract and therefore provide better quality of life. The data collection methods described have been found to vary between questionnaires and rating scales, diaries, physical markers and group interviews. Conclusion: Patients with IBS and/or FD can make use of many diet related self-care methods to prevent and/or relieve their symptoms from the gastrointestinal tract. Many different data collection methods can be used to identify diet related self-care practices and its effect on the symptoms of IBS and/or FD.

Diss. (sammanfattning) Stockholm : Karolinska institutet, 2007. / Härtill 4 uppsatser.

Diss. (sammanfattning) Stockholm : Karolinska institutet, 2007. / Härtill 4 uppsatser.

Bakgrund: Irritable Bowel Syndrome (IBS) är en vanlig mag- och tarmsjukdom som är dubbelt så vanlig hos kvinnor som hos män. Orsaken till IBS är inte fastställd dock kan de fysiska symtomen ha koppling till den psykiska hälsan. Studier visar att kvinnor och män ofta har olika symtom. Behandlingen för IBS verkar endast symtomlindrande eftersom det inte finns något botemedel för IBS i dagsläget. Det är viktigt att sjuksköterskor har kunskap om betydelsen av genus i vården med tanke på att kvinnor och män idag inte har samma förutsättningar i vården. Sjuksköterskor kommer möta personer med IBS i vården och majoriteten kommer att vara kvinnor, det är därför av betydelse att vara medveten om deras upplevelse av sjukdomen för att kunna ge dessa kvinnor bästa möjliga vård. Syfte: Syftet var att belysa kvinnliga patienters upplevelse av att leva med Irritable Bowel Syndrome (IBS). Metod: Metoden som användes var en litteraturöversikt. Författarna använde sig av elva artiklar till resultatdelen som hämtades från tre olika databaser, CINAHL complete, PubMed samt Medline. Fokus låg på artiklar med kvalitativ design dock användes även en artikel med kvantitativ design. Resultat: När författarna analyserade artiklarna trädde fem teman fram. Dessa teman var Sociala svårigheter och begränsningar, Att leva med en förändrad kropp, Hjälplöshet på grund av oförutsägbara symtom, Känslor av skam samt Misstro i mötet med vården. Diskussion: Resultatet diskuterades utifrån Roys adaptionsmodell, vetenskaplig forskning och litteratur samt författarnas egna reflektioner. Författarna valde att diskutera de delar av resultatet som ansågs av dem vara viktigast. / Background: Irritable Bowel Syndrome (IBS) is a common stomach and intestinal disease that is twice as common in women as in men. The cause of IBS has not been determined, however, the physical symptoms may be related to mental health. Studies show that women and men often experience different symptoms. The treatment for IBS is only symptom-relieving as there is no cure for IBS at the present time. It is important that nurses have knowledge of the importance of gender in health care, given that women and men today do not have the same conditions in health care. Nurses will meet people with IBS and the majority will be women, therefore it is important to be aware of their experience of the disease in order to provide these women with the best possible care. Aim: The aim was to enlighten how it is for women to live with Irritable Bowel Syndrome (IBS). Method: The method used for this study was a literature review. The authors used eleven articles for the result which were obtained from three different databases, CINAHL complete, PubMed and Medline. The focus was set on articles with a qualitative design, an article with a quantitative design was also used. Results: When the authors analyzed the articles, five themes emerged. These themes were Social hardships and limitations, Living with a changed body, Helplessness due to unpredictable symptoms, Feelings of shame as well as Missbelief in the meeting with healthcare. Discussion: The result was chosen to be discussed based on Roy's adaptation model. The authors chose to discuss the parts of the result that were considered to be the most important.

Irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD) are two of the most commonly diagnosed chronic digestive disorders in Western countries with increasing prevalence among Canadians. However, the etiology of IBS and IBD remain poorly understood due to a complex interplay of genetic, psychosocial and environmental factors, which hampers efforts at early detection/screening, accurate diagnosis and effective treatments notably in children. This thesis aims to reveal new biochemical insights into the pathophysiology underlying IBS and IBD when using an untargeted metabolite profiling (i.e., metabolomics) approach on urine and stool specimens based on multisegment injection-capillary electrophoresis-mass spectrometry (MSI-CE-MS). Chapter I reviews brief history and current challenges in diagnosis and treatment, as well as current metabolomics literature of IBS and IBD. Chapter II first develops a robust method for high throughput profiling of anionic metabolites in human urine samples when using MSI-CE-MS. For the first time, we demonstrate that incidental capillary fractures are caused by irreversible aminolysis of the outer polyimide coating due to the frequent use of volatile ammonia based buffers under alkaline conditions (pH > 9) in electrospray ionization-MS. Chapter III subsequently applies this validated method to investigate differentially excreted urinary metabolites between adult IBS patients and healthy controls, which indicated significantly accelerated rates of collagen degradation and cell turn-over in IBS patients. Chapter IV later develops a novel stool extraction protocol for characterization of the fecal metabolome together with meta-genomic data for elucidating complex host-gut microflora interactions from a cohort of pediatric IBD patients, including Crohn’s disease and ulcerative colitis. In this pilot study, a panel of discriminating metabolites in urine is shown to allow for differential diagnosis of major pediatric IBD sub-types as an alternative to colonoscopy and histopathology that are invasive, expensive and prone to ambiguous test results. Finally, Chapter V involves a longitudinal metabolomics study that aims to identify metabolic trajectories that predict treatment responses of a cohort of pediatric Crohn’s disease patients following initiation of exclusive enteral nutrition (EEN) therapy. In the end, Chapter VI highlights major outcomes of thesis and future direction of metabolomics in IBS and IBD with a specific focus on improved stool specimen collection and validation of biomarker specificity relative to other related gastrointestinal disorders. In summary, this thesis has demonstrated metabolic processes that are associated with exacerbation of symptoms or remission in subset of IBS and pediatric IBD patients. With follow up studies with larger cohort of patients, potential biomarkers identified in this thesis will contribute the development of more accurate and non-invasive decision making process for diagnosis and treatment, resulting in long-lasting remission and improved quality of life of patients suffering from chronic digestive disorders. / Thesis / Doctor of Science (PhD)

Inflammatorisk tarmsjukdom blir allt vanligare. Sjukdomen är kronisk och kommer följa patienten för resten av livet. Sjuksköterskan behöver kunskap om patientens upplevelser av att leva med inflammatorisk tarmsjukdom för att kunna ge stöd och god omvårdnad. Syftet med litteraturstudien var att belysa patientens upplevelser av att leva med inflammatorisk tarmsjukdom. Metoden för litteraturstudien utformades efter niostegsmodellen av Polit och Beck (2012). En systematisk litteratursökning gjordes i databaserna Cinahl, PsycInfo och PubMed. En urvalsprocess i tre steg gjordes, där artiklarna bearbetades och kvalitetsgranskades. Elva artiklar inkluderades till resultatet, varav åtta kvalitativa studier, en kvantitativ studie och två kvalitativ-kvantitativ mixade metoder. Resultatet framställdes i sju kategorier som belyser patientens upplevelser av att leva med inflammatorisk tarmsjukdom. Kategorierna presenterar maktlöshet och frustration, social isolering, oro och rädsla, upplevelse av smärta, upplevelse av fatigue, att känna skuld och att känna kontroll över sin sjukdom. Litteraturstudiens slutsats beskriver att inflammatorisk tarmsjukdom bidrar till begränsningar i vardagen. Sjuksköterskan behöver kunskap om patientens upplevelse av att leva med inflammatorisk tarmsjukdom för att kunna ge stöd, och på så sätt bidra till att patienten lär sig leva med sin sjukdom.

BACKGROUND: Constipation is highly prevalent in older adults and may be associated with greater frequency of acute exacerbation of chronic obstructive pulmonary disease (AECOPD). We investigated the prevalence of lower defecation frequency (DF) and risk factors (including AECOPD) associated with lower DF among hospitalized elderly patients. METHODS: We conducted a retrospective case-control study in a community hospital of Southeast Ohio. Adults aged 65 years or older admitted during 2004 and 2006 were reviewed (N = 1288). Patients were excluded (N = 212) if their length of stay was less than 3 days, discharge diagnosis of Clostridium difficile-associated diarrhea, death or ventilator- dependent respiratory failure during hospitalization. Lower DF was defined as either an average DF of 0.33 or less per day or no defecation in the first three days of hospitalization; cases (N = 406) and controls (N = 670) were included for the final analysis. RESULTS: Approximately 38% had lower DF in this patient population. Fecal soiling/smearing of at least two episodes was documented in 7% of the patients. With the adjustment of confounders, AECOPD (adjusted odds ratio [AOR] =1.47, 95% confidence interval [CI] =1.01-2.13) and muscle relaxant use (AOR =2.94; 95% CI =1.29-6.69) were significantly associated with lower DF. Supplementation of potassium and antibiotic use prior to hospitalization was associated with lower risk of lower DF. CONCLUSIONS: Approximately 38% of hospitalized older adults had lower DF. AECOPD and use of muscle relaxant were significantly associated with lower DF; while supplementation of potassium and antibiotic use were protective for lower DF risk after adjusting for other variables.

No description available.

No description available.

No description available.