DR Medhat MRCP

سؤال امتحان Melanosis coli
- Is a disorder of pigmentation of the bowel wall.
- Histology demonstrates pigment-laden macrophages.
- It is associated with laxative abuse, especially anthraquinone compounds such as
senna.
- It`s benign , no complications.
Pigment-laden macrophages.
Irritable bowel syndrome (IBS)
- It`s a chronic ,relapsing & often life-long functional (i.e without organic cause) bowel
disorder .
- It`s a symptom-based diagnosis.
• Diagnosis (NICE 2008):
- The diagnosis of IBS should be considered if the patient has had the following for at
least 6 months :
Abdominal pain
- Relieved by defecation OR
- Associated with altered bowel frequency stool form, in addition to 2 of the
following 4 symptoms:
1) Altered stool passage (straining, urgency, incomplete evacuation).
2) Abdominal bloating (more common in women than men), distension,
tension or hardness
3) Symptoms made worse by eating.
4) passage of mucus
Bloating, and/or
Change in bowel habit.
- Features such as lethargy, nausea, backache and bladder symptoms may also support
the diagnosis.
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