Major Diseases

Irritable bowel syndrome

(IBS) is characterised by recurrent abdominal pain in association with abnormal defecation in the absence of a structural abnormality of the gut. . Nevertheless, IBS is the most common cause of gastrointestinal referral and accounts for frequent absenteeism from work and impaired quality of life. Young women are affected 2–3 times more often than men. Coexisting conditions, such as non-ulcer dyspepsia, chronic fatigue syndrome, dysmenorrhoea and fibromyalgia, are common. Between 5 and 10% of patients have a history of physical or sexual abuse.

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Acidity

Gastro-oesophageal reflux resulting in heartburn affects approximately 30% of the general population CAUSES

Aspirin, NSAIDs

• H. pylori
• Alcohol
• Other drugs, e.g. iron preparations
• Severe physiological stress, e.g. burns, multi-organ failure,

CNS trauma

• Bile reflux
• Viral infections

INFLAMMATORY BOWEL DISEASE
Ulcerative colitis and Crohn’s disease are chronic inflammatory bowel diseases which pursue a protracted relapsing and remitting course, usually extending over years. The diseases have many similarities and it is sometimes impossible to differentiate between them. A crucial distinction is that ulcerative colitis only involves the colon, while Crohn’s disease can involve any part of the gastrointestinal tract from mouth to anus.

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Constipation

Constipation is defined as infrequent passage of hard stools. Patients may also complain of straining, a sensation of incomplete evacuation and either discomfort. Constipation may occur in many gastrointestinal and other medical disorders

Causes of constipation

Gastrointestinal disorders

Dietary

• Lack of fibre and/or fluid intake

Motility

• Slow-transit constipation
• Irritable bowel syndrome

Structural

• Colonic carcinoma
• Diverticular disease
• Hirschsprung’s disease

Defecation

Crohn’s,fissures, haemorrhoids

• Obstructed defecation

Non-gastrointestinal disorders

Drugs

• Opiates
• Iron supplements
• Antacids

Neurological

• Multiple sclerosis
• Spinal cord lesions

Metabolic/endocrine

• Diabetes mellitus
• Hypercalcaemia
• Hypothyroidism
• Pregnancy

Others

• Any serious illness with immobility, especially in the elderly

• Depression

Disorders causing malabsorption

 Coeliac disease WHEAT ALLERGY

Coeliac disease is an inflammatory disorder of the small bowel occurring in genetically susceptible individuals, which results from intolerance to wheat gluten and similar proteins found in rye, barley and, to a lesser extent, oats. It can result in malabsorption and responds to a gluten-free diet. The condition occurs worldwide but is more common in northern Europe. The prevalence in the UK is approximately 1%, although 50% of these people are asymptomatic.

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Diarrhea

Diarrhoea is defined as the passage of more than 200 g of stool daily, and measurement of stool volume is helpful in confirming this. The most severe symptom in many patients is urgency of defecation, and faecal incontinence.

Acute diarrhoea
This is extremely common and is usually due to faecal–oral transmission of bacteria or their toxins, viruses. Infective diarrhoea is usually shortlived and patients who present with a history of diarrhoea lasting more than 10 days rarely have an infective cause.

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Hypertension

Within any population, blood pressure values occur within a continuum, and are determined by mechanical, hormonal and environmental factors. Systemic BP rises with age, and the incidence of cardiovascular disease  is closely related to average BP at all ages, even when BP readings are within the so-called normal range.

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Atherosclerosis

Atherosclerosis can affect any artery in the body. When it occurs in the heart, it may cause angina, MI and sudden death; in the brain, stroke and transient ischaemic attack ; and in the limbs, claudication and critical limb ischaemia.

Risk factors
Age and sex
Age is the most powerful independent risk factor for atherosclerosis. Pre-menopausal
women have lower rates of disease than men, although this sex difference disappears after the
menopause

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Pneumonia

Pneumonia is as an acute respiratory illness associated with recently developed radiological pulmonary shadowing, which may be segmental, lobar or multilobar.

The context in which pneumonia develops is highly indicative of the likely organism involved;
therefore, pneumonias are usually classified as community-or hospital-acquired, or as occurring in immunocompromised hosts.

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Asthma

Asthma is a chronic inflammatory disorder of the airways, in which many cells and play a role. The chronic inflammation is associated with airway hyper-responsiveness that leads to recurrent episodes of wheezing, breathlessness, chest tightness and coughing, particularly at night and in the early morning.

These episodes are usually associated with widespread but variable airflow obstruction within the lung that is often reversible .

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Cough

Cough is the most frequent symptom of respiratory disease and is caused by stimulation of sensory nerves in the mucosa of the pharynx, larynx, trachea and bronchi. Changes in air temperature or exposure to irritants, such as cigarette smoke or perfumes. The characteristics of cough originating at various levels of the respiratory tract.

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Seizures(EPILEPSY)

The diagnosis of generalised tonic–clonic seizures, in which there is loss of consciousness, falling to the ground and clonic movements, is easy but lack of eyewitness accounts can leave uncertainty.

Less dramatic seizures, such as absences or some focal seizures which cause alteration of consciousness without the patient falling to the ground, may merely be experienced as ‘lost time’. Since epileptic seizures are the result of specific processes that vary from patient to patient, their manifestation tends to be intermittent and stereotyped and often clusters in time, for reasons incompletely understood.

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