JAMA: Malabsorption Topic Collection

Irritable Bowel Syndrome

Torpy JM, Golub RM. — Wed, 05 Oct 2011 00:00:00 GMT

Irritable bowel syndrome (IBS) affects the gastrointestinal (GI) tract, especially the colon (the large bowel). Irritable bowel syndrome causes diarrhea and sometimes constipation (difficulty with bowel movements). Approximately 20% of persons in the developed world have IBS symptoms at some time in their lives. Irritable bowel syndrome is generally diagnosed when more serious problems like inflammatory bowel disease (Crohn disease and ulcerative colitis), celiac disease, infection with parasites, cancer, or malabsorption (bowel does not absorb nutrients properly) have been looked for and not found. Women are more likelythan men to have IBS. People who have continuous or recurring diarrhea, constipation, or both are often referred to a gastroenterologist, a doctor with specialized education in the management of digestive diseases, including bowel problems. Irritable bowel syndrome is called a functional disorder because there is no known physical cause for its signs and symptoms. It is important to seek medical attention if you have episodes of diarrhea or constipation on a regular basis, have a change in your bowel habits, or experience bloody stools because these may be signs of serious medical issues, such as colon or rectal cancer or inflammatory bowel disease.

Celiac Disease

Chang HJ, Burke AE, Golub RM. — Wed, 12 Oct 2011 00:00:00 GMT

Celiac disease (CD) is a common digestive disease. It is also known as celiac sprue, gluten-sensitive enteropathy, or nontropical sprue. In individuals with CD, gluten (a protein in wheat, barley, and rye) damages the small intestine and results in difficulty absorbing nutrients from food. Up to 1 in 113 people in the United States have CD. The risk is higher (1 in 22) in people with a first-degree relative with CD. The cause of CD is unknown, but environmental, immunologic, and genetic factors all contribute. The October 12, 2011, issue of JAMA includes an article about CD. This Patient Page is based on one originally published in the September 16, 2009, issue of JAMA.

Celiac Disease Diagnosis and Management A 46-Year-Old Woman With Anemia

Leffler D. — Wed, 12 Oct 2011 00:00:00 GMT

Celiac disease is one of the most prevalent autoimmune gastrointestinal disorders, but as the case of Ms J illustrates, diagnosis is often delayed or missed. Based on serologic studies, the prevalence of celiac disease in many populations is estimated to be approximately 1% and has been increasing steadily over the last 50 years. Evaluation for celiac disease is generally straightforward and uses commonly available serologic tests; however, the signs and symptoms of celiac disease are nonspecific and highly heterogeneous, making diagnosis difficult. Although celiac disease is often considered a mild disorder treatable with simple dietary changes, in reality celiac disease imparts considerable risks, including reduced bone mineral density, impaired quality of life, and increased overall mortality. In addition, a gluten-free diet is highly burdensome and can profoundly affect patients and their families. For these reasons, care of individuals with celiac disease requires prompt diagnosis and ongoing multidisciplinary management.