Post a summary of the interview and a description of the communication techniques you would use with your assigned patient. Explain why you would use these techniques. Identify the risk assessment instrument you selected, and justify why it would be applicable to the selected patient. Provide at least five targeted questions you would ask the patient.

                                       Main Post

Week 1 Advanced Health Assessment 

Initial Post 

My patient: 38-year-old Native American pregnant female living on a reservation 

Each patient you meet you will have different techniques and ways of going about communication with them depending on their culture and beliefs. It is important to understand what is important to them. Ask yourself what do they value most? You want to be able to connect with them to get an accurate history to provide care.  The nursing assessment includes gathering information concerning the patient’s individual physiological, psychological, sociological, and spiritual needs. It is the first step in the successful evaluation of a patient. (Jamieson H,2019)In my situation with my patient being of the Native American decent livening on a reservation whom is pregnant I can already assume she does not have much interaction with the outside world such as those outside the reservation. She mainly probably stays with those who live around her and live off the land with little unhealthy habits since nature is very important in this culture. 

My interview techniques to obtain a health history would need to be based on her lifestyle. I need to make sure I am wording them correctly so that she can understand what I am needing from her. Certain health information that is important to us may not be pertinent to the patient. I need to target my questions towards her lifestyle. The function of the initial nursing assessment is to identify the assessment parameters and responsibilities needed to plan and deliver appropriate, individualized care to the patient. (Gray LC,2018) I also need to base a lot of my question on the fact she is pregnant. I need to ensure she Is healthy not only for herself but for the baby. I may have to redirect and reword my question multiple times to obtain accurate information. With this patient living on a reservation I need to ask about her diet and environmental factors since my way of life Is different than hers I need to first understand how she lives. The cultural competency assessment will identify factors that may impede the implementation of nursing diagnosis and care. (Dunham M,2018)I then need to focus on potential health risk based on first this patient age. This patient is 38 years old and is pregnant. This is automatically a high-risk pregnancy due to her age. 35 is considered geriatric pregnancy. This increase the risk for many health concerns for her and the baby. Also, her living situation can at time be difficult for her and baby depending on what type of reservation she lives on. I need to ensure she has quick access to medical care and is receiving the proper supplements. Many native American cultures believe in herbal and home remedies which can sometimes be harmful or interact with other medications. Some questions that need to be asked I order to obtain an accurate health history are the following: Do you have any allergies to medication?Is this your first child? If not, how many children do you have, and did you have a C-section?
What medication including herbal supplements are you taking?Have you ever had any major surgeries?Have you ever been hospitalized for any reason including mental health reasons? What is your family history?Have you been having any complications that you have noticed or concerns?  

                                                       References

Jamieson H, Abey-Nesbit R, Bergler U, Keeling S, Schluter PJ, Scrase R, Lacey C. Evaluating the Influence of Social Factors on Aged Residential Care Admission in a National Home Care Assessment Database of Older Adults. J Am Med Dir Assoc. 2019 Mar 26;Gray LC, Beattie E, Boscart VM, Henderson A, Hornby-Turner YC, Hubbard RE, Wood S, Peel NM. Development and Testing of the interRAI Acute Care: A Standardized Assessment Administered by Nurses for Patients Admitted to Acute Care. Health Serv Insights. 2018 Dunham M, MacInnes J. Relationship of Multiple Attempts on an Admissions Examination to Early Program Performance. J Nurs Educ. 2018 Oct 01;57(10):578-583.

 

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Respond to the Main post bellow, in one or more of the following ways:

Ask a probing question, substantiated with additional background information, and evidence.

Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.

Offer and support an alternative perspective using readings from  the classroom or from your own review of the literature in the Walden  Library.

Validate an idea with your own experience and additional sources.

Make a suggestion based on additional evidence drawn from readings or after synthesizing multiple postings.

Expand on your colleagues’ postings by providing additional insights or contrasting perspectives based on readings and evidence.

 

                                               Initial post 

An intervention program to promote health-related physical fitness in Nurses

Nursing  is a very stressful profession and has become more demanding in recent  years. (Kuo, H.-W, 2009, P. 1404) With nursing being increasingly  demanding and strenuous it is important for the nurse to take care of  themselves. Regular exercise can help maintain a healthier lifestyle.  This will always be beneficial not only to the nurse working with the  patients but for the patients as well to have a healthy example of a  current lifestyle. 

In  this study 90 nurses were chosen. These nurses came from five different  hospitals. They were separated into two groups experimental and  controlled. Experimental groups are those who are being exposed to a  variable to receive an outcome. (Steadmans Medical Dictionary, 2002)   Controlled group is not being exposed to this variable. In this case  the variable is exercise on the treadmill for three months. Nurses were  exposed to treadmill exercise for three months to see what type of  results they obtained compared to those who were not active. This study  demonstrates that the development and implementation of an intervention  program can promote 

health-related physical fitness of nurses. (Kuo, H.-W, 2009, P. 1404)

I  do think this is very relevant to our practice because the nurses are  benefiting in a health manner. The extent to which results are  consistent over time and an accurate representation of the total  population under study is referred to as reliability. (Golafshani,  2003)It is important as healthcare workers to live a healthy lifestyle  so that when we educate our patients they are able to see an example. It  also helps nurses be able to release stress in a healthy way and  reduces the risk of many disease. Staying active will help with patient  care when it comes to taking care of our patient at the bedside and will  help us keep our energy for longer periods of time since most of the  day we are on your feet. 

Yuan,  S.-C., Chou, M.-C., Hwu, L.-J., Chang, Y.-O., Hsu, W.-H., & Kuo,  H.-W. (2009). an intervention program to promote health-related physical  fitness in nurses. Journal of Clinical Nursing, 18(10), 1,404–1,411.

Experimental Group.” Dictionary.com, Steadmans Medical Dictionary, 2002, www.dictionary.com/browse/experimental-group.

Golafshani,  N. (2003). Understanding Reliability and Validity in Qualitative  Research. The Qualitative Report, 8(4), 597-606. Retrieved from  https://nsuworks.nova.edu/tqr/vol8/iss4/6

 

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Respond on two different days who selected different treatments and factors than you, in the following ways:

Offer alternative common treatments for the disorders.

Share insight on how the factor you selected impacts the treatment of alterations of digestive function.

                                                        Main Post

Many patients will present with disease processes that have the same or similar symptoms, and it will be the responsibility of the practitioner to diagnose and provide treatment accurately. The gastrointestinal tract is one area where misdiagnoses occur due to the common signs and symptoms. Inflammatory bowel disease and irritable bowel syndrome are two common misdiagnosed disorders that will be explored, the pathophysiology explained, proper treatment, and the effects gender has on these diseases.

Pathophysiology of Inflammatory Bowel Disease and Irritable Bowel Syndrome 

Inflammatory bowel disease (IBD) comprises three key disorders; Crohn’s disease (CD), ulcerative colitis (UC), and microscopic colitis all attributed to an inflammation process but each affects the body differently. Research by El-Salhy and Hausken (2016) explains that the inflammation in Crohn’s disease is transmural in nature and occurs in any part of the gastrointestinal tract, while the inflammation in ulcerative colitis is more superficial and affects the rectocolonic mucosa, and the inflammation in microscopic manifests as mucosal and submucosal infiltration of immune cells without ulcerations or crypt abscesses and occurs in the colon.

Irritable bowel syndrome (IBS) is a common disease, although the pathophysiology is still not fully understood. Combination of low-grade mucosal inflammation with visceral hypersensitivity and impaired bowel motility could be the underlying etiology for IBS pathogenesis (Chong et al., 2019). Alterations in the gut microbiota and dietary choices play a central role in disease development. According to O’Malley (2019), IBS is complex multifactorial pathophysiology, that involves dysfunction of the bi-directional signaling axis between the brain and the gut, this axis incorporates efferent and afferent branches of the autonomic nervous system, circulating endocrine hormones and immune factors, local paracrine and neurocrine factors and microbial metabolites. 

Treatments for Inflammatory Bowel Disease and Irritable Bowel Syndrome

Treatment for IBS and IBD focuses on treating not only the symptoms but the underlying cause of the disease. Treatment for IBS includes; dietary interventions, probiotics, prebiotics, synbiotics, non-absorbable antibiotics, mixed μ-opioid receptor agonist–δ-opioid receptor antagonist and κ-opioid receptor agonist, Serum-derived bovine immunoglobulin (SBI), and fecal microbiota transplantation (FMT).  Treatment for IBD is more complex due to IBD being composed of three different diseases, each requires different treatment plans, but there is some crossover. Corticosteroids, probiotics, immunomodulatory drugs, immunosuppressants, antitumor necrosis factor therapy, anti-interleukin 12/23 antibody drugs, janus kinase (JAK) inhibitor, SMAD 7 inhibitor, and FMT are treatments available for IBD. 5-aminosalicylates (5-ASAs) are the first-line therapy for induction and maintenance of remission in patients with UC (Su et al., 2019). Anti-tumor necrosis factor (TNF) therapy works well on both UC and CD, JAK inhibitor works for UC and not CD, SMAD 7 inhibitor works for CD but not UC.

Gender’s Affect on Inflammatory Bowel Disease and Irritable Bowel Syndrome

Research conducted by Kosako, Akiho, Miwa, Kanazawa, and Fukudo (2018) acknowledges that the higher prevalence of IBS in women compared with men may be associated with sex hormone fluctuations, which reportedly affect IBS symptoms, with symptoms appearing stronger before menstruation. Women may also receive a delay in treatment to both IBD and IBS due to the perceived perception of pain being misdiagnosed by the primary care practitioner. 

Conclusion

The gastrointestinal tract has many disorders where the signs and symptoms are the same. It is imperative that the practitioner distinguishes between diseases as the therapies can become complicated. The practitioner must do a comprehensive physical exam, as well as a health history with the patient to determine the path towards diagnosis. Laboratory data and imaging can also play a key role in determining the proper treatment plan and diagnosis. Unsuccessful medical treatment will warrant more invasive procedures in an attempt to visualize the underlying issue.

 

                                                                                                                                 References

Chong, P. P., Chin, V. K., Looi, C. Y., Wong, W. F., Madhavan, P., & Yong, V. C. (2019). The Microbiome and Irritable Bowel Syndrome–A Review on the Pathophysiology, Current Research and Future Therapy. Frontiers in Microbiology, 10, 1136.. https://doi-org.ezp.waldenulibrary.org/10.3389/fmicb.2019.01136

El-Salhy, M., & Hausken, T. (2016). The role of the neuropeptide Y (NPY) family in the pathophysiology of inflammatory bowel disease (IBD). Neuropeptides, 55, 137–144. https://doi-org.ezp.waldenulibrary.org/10.1016/j.npep.2015.09.005

Kosako, M., Akiho, H., Miwa, H., Kanazawa, M., & Fukudo, S. (2018). Impact of symptoms by gender and age in Japanese subjects with irritable bowel syndrome with constipation (IBS-C): A large population-based internet survey. BioPsychoSocial Medicine, 12(1). https://doi-org.ezp.waldenulibrary.org/10.1186/s13030-018-0131-2

O’Malley, D. (2019). Endocrine regulation of gut function – a role for glucagon‐like peptide‐1 in the pathophysiology of irritable bowel syndrome. Experimental Physiology, 104(1), 3–10. https://doi-org.ezp.waldenulibrary.org/10.1113/EP087443

Su, H.-J., Chiu, Y.-T., Chiu, C.-T., Lin, Y.-C., Wang, C.-Y., Hsieh, J.-Y., & Wei, S.-C. (2019). Inflammatory bowel disease and its treatment in 2018: Global and Taiwanese status updates. Journal of the Formosan Medical Association, 118(7), 1083–1092. https://doi-org.ezp.waldenulibrary.org/10.1016/j.jfma.2018.07.005Many patients will present with disease processes that have the same or similar symptoms, and it will be the responsibility of the practitioner to diagnose and provide treatment accurately. The gastrointestinal tract is one area where misdiagnoses occur due to the common signs and symptoms. Inflammatory bowel disease and irritable bowel syndrome are two common misdiagnosed disorders that will be explored, the pathophysiology explained, proper treatment, and the effects gender has on these diseases.

Pathophysiology of Inflammatory Bowel Disease and Irritable Bowel Syndrome 

Inflammatory bowel disease (IBD) comprises three key disorders; Crohn’s disease (CD), ulcerative colitis (UC), and microscopic colitis all attributed to an inflammation process but each affects the body differently. Research by El-Salhy and Hausken (2016) explains that the inflammation in Crohn’s disease is transmural in nature and occurs in any part of the gastrointestinal tract, while the inflammation in ulcerative colitis is more superficial and affects the rectocolonic mucosa, and the inflammation in microscopic manifests as mucosal and submucosal infiltration of immune cells without ulcerations or crypt abscesses and occurs in the colon.

Irritable bowel syndrome (IBS) is a common disease, although the pathophysiology is still not fully understood. Combination of low-grade mucosal inflammation with visceral hypersensitivity and impaired bowel motility could be the underlying etiology for IBS pathogenesis (Chong et al., 2019). Alterations in the gut microbiota and dietary choices play a central role in disease development. According to O’Malley (2019), IBS is complex multifactorial pathophysiology, that involves dysfunction of the bi-directional signaling axis between the brain and the gut, this axis incorporates efferent and afferent branches of the autonomic nervous system, circulating endocrine hormones and immune factors, local paracrine and neurocrine factors and microbial metabolites. 

Treatments for Inflammatory Bowel Disease and Irritable Bowel Syndrome

Treatment for IBS and IBD focuses on treating not only the symptoms but the underlying cause of the disease. Treatment for IBS includes; dietary interventions, probiotics, prebiotics, synbiotics, non-absorbable antibiotics, mixed μ-opioid receptor agonist–δ-opioid receptor antagonist and κ-opioid receptor agonist, Serum-derived bovine immunoglobulin (SBI), and fecal microbiota transplantation (FMT).  Treatment for IBD is more complex due to IBD being composed of three different diseases, each requires different treatment plans, but there is some crossover. Corticosteroids, probiotics, immunomodulatory drugs, immunosuppressants, antitumor necrosis factor therapy, anti-interleukin 12/23 antibody drugs, janus kinase (JAK) inhibitor, SMAD 7 inhibitor, and FMT are treatments available for IBD. 5-aminosalicylates (5-ASAs) are the first-line therapy for induction and maintenance of remission in patients with UC (Su et al., 2019). Anti-tumor necrosis factor (TNF) therapy works well on both UC and CD, JAK inhibitor works for UC and not CD, SMAD 7 inhibitor works for CD but not UC.

Gender’s Affect on Inflammatory Bowel Disease and Irritable Bowel Syndrome

Research conducted by Kosako, Akiho, Miwa, Kanazawa, and Fukudo (2018) acknowledges that the higher prevalence of IBS in women compared with men may be associated with sex hormone fluctuations, which reportedly affect IBS symptoms, with symptoms appearing stronger before menstruation. Women may also receive a delay in treatment to both IBD and IBS due to the perceived perception of pain being misdiagnosed by the primary care practitioner. 

Conclusion

The gastrointestinal tract has many disorders where the signs and symptoms are the same. It is imperative that the practitioner distinguishes between diseases as the therapies can become complicated. The practitioner must do a comprehensive physical exam, as well as a health history with the patient to determine the path towards diagnosis. Laboratory data and imaging can also play a key role in determining the proper treatment plan and diagnosis. Unsuccessful medical treatment will warrant more invasive procedures in an attempt to visualize the underlying issue.

 

                                                                                                                                 References

Chong, P. P., Chin, V. K., Looi, C. Y., Wong, W. F., Madhavan, P., & Yong, V. C. (2019). The Microbiome and Irritable Bowel Syndrome–A Review on the Pathophysiology, Current Research and Future Therapy. Frontiers in Microbiology, 10, 1136.. https://doi-org.ezp.waldenulibrary.org/10.3389/fmicb.2019.01136

El-Salhy, M., & Hausken, T. (2016). The role of the neuropeptide Y (NPY) family in the pathophysiology of inflammatory bowel disease (IBD). Neuropeptides, 55, 137–144. https://doi-org.ezp.waldenulibrary.org/10.1016/j.npep.2015.09.005

Kosako, M., Akiho, H., Miwa, H., Kanazawa, M., & Fukudo, S. (2018). Impact of symptoms by gender and age in Japanese subjects with irritable bowel syndrome with constipation (IBS-C): A large population-based internet survey. BioPsychoSocial Medicine, 12(1). https://doi-org.ezp.waldenulibrary.org/10.1186/s13030-018-0131-2

O’Malley, D. (2019). Endocrine regulation of gut function – a role for glucagon‐like peptide‐1 in the pathophysiology of irritable bowel syndrome. Experimental Physiology, 104(1), 3–10. https://doi-org.ezp.waldenulibrary.org/10.1113/EP087443

Su, H.-J., Chiu, Y.-T., Chiu, C.-T., Lin, Y.-C., Wang, C.-Y., Hsieh, J.-Y., & Wei, S.-C. (2019). Inflammatory bowel disease and its treatment in 2018: Global and Taiwanese status updates. Journal of the Formosan Medical Association, 118(7), 1083–1092. https://doi-org.ezp.waldenulibrary.org/10.1016/j.jfma.2018.07.005

 

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Respond on two different days who selected different alterations and factors than you, in one or more of the following ways:

Share insights on how the factor you selected impacts the cardiovascular alteration your colleague selected.

Offer and support an alternative perspective using readings from the classroom or from your own research in the Walden Library.

Validate an idea with your own experience and additional research.

                                                       Main Post

The purpose of this paper is to explore coronary artery disease (CAD), the roles of hypertension and dyslipidemia affect CAD, and exploring if genetics is a factor in CAD. The progression of CAD can lead to myocardial ischemia, infarction, and even death if left untreated. Heart disease remains the number one cause of death in the United States, and understanding these factors plays a continued role in developing strategies, both preventive and treatment efforts.

                                                Coronary Artery Disease 

CAD is normally the result of atherosclerosis, the build-up of plaque due to damaged endothelium that allows fat to accumulate and decrease the diameter of the vessel. The decrease in vessel size allows for blockage and decreased blood flow to the coronary vessel; this leads to ischemia, where the cells are deprived of blood and begin the process of dying if left untreated. Persistent ischemia or the complete occlusion of a coronary artery causes the acute coronary syndromes, including infarction, or irreversible myocardial damage (Huether & McCance, 2017). Also, known as a heart attack or myocardial infarction (MI). Fortunately, the incidence and mortality statistics for CAD have been decreasing over the past 15 years because of more aggressive recognition, prevention, and treatment (Huether & McCance, 2017). 

                         Hypertension’s Role in Coronary Artery Disease 

Hypertension is a consistent elevation of systemic arterial blood pressure (Huether & McCance, 2017).  Fortunately, hypertension a key factor in CAD is modifiable and can be monitored closely to prevent further disease progression. Hypertension is common; it ranks as the number one primary diagnosis in America. Pathophysiological mechanisms of blood pressure as a risk factor for CAD are complex and include the influence of blood pressure as a physical force on the development of the atherosclerotic plaque, and the relationship between pulsatile hemodynamics/arterial stiffness and coronary perfusion (Weber et al., 2016). The presence of hypertension further increases the risk of CAD and may explain why some individuals are more predisposed than others to developing coronary events (Rosendorff et al., 2015). Pathophysiological mechanisms of blood pressure as a risk factor for CAD are complex and include the influence of blood pressure as a physical force on the development of the atherosclerotic plaque, and the relationship between pulsatile hemodynamics/arterial stiffness and coronary perfusion (Weber et al., 2016). Hypertension, when diagnosed early, can be treated accordingly, decreasing the opportunity for the role of exacerbation of CAD.

                       Dyslipidemia’s Role in Coronary Artery Disease

 Huether & McCance (2017) define dyslipidemia as an abnormal concentration of serum lipoproteins, the result of genetic and dietary factors. The hardening aspect of this disease is the result of cholesterol deposits in the vessel, which decrease elasticity and make the vessel wall stiff  (Marsh & Rizzo, 2019). The elevation of lipoproteins creates a narrowing of the vessel diameter, which in turn decreases blood flow to arteries. When dyslipidemia occurs in the coronary arteries, the decreased blood flow can lead to ischemia or infarct, depending on the size of the blockage. Controlling the progression of the disease is important, modifying lifestyle habits; diet and physical activity can help to prevent further complications. Medications are also available to keep lipid levels balanced. 

Genetics Affects of Risk Factors in Coronary Artery Disease

Dyslipidemia is known as a heritable risk factor for CAD; patients with a family history should inform their practitioner to manage the disease process in the early state. Plasma lipids and lipoproteins are heritable risk factors for CAD, with heritability estimates ranging from 40% to 60% (Tada, Kawashiri, & Yamagishi, 2017). The best treatment is prevention, knowing a patient’s family history is paramount in controlling the lipid levels and keeping them at rates that will prevent CAD. Monitoring labs and dietary modifications assist those with family history and can avoid the progression of CAD. 

Conclusion

Cardiovascular disease is still the leading cause of premature death world-wide with factors like abdominal obesity, hypertension and dyslipidemia being central risk factors in the etiology (Lidin, Hellénius, Rydell-Karlsson, & Ekblom-Bak, 2018). Hypertension and dyslipidemia both can accelerate the development of CAD. Fortunately, both factors are modifiable and are manageable by lifestyle modifications. Genetics plays a role in both hypertension and dyslipidemia; obtaining an accurate family history allows for early monitoring and controlling the modifiable factors, diet, and physical activity can keep both hypertension and dyslipidemia well controlled. 

 

                                                                                                                                                  References

Huether, S. E., & McCance, K. L. (2017). Understanding pathophysiology (6th ed.). St. Louis, MO: Mosby.

Lidin, M., Hellénius, M.-L., Rydell-Karlsson, M., & Ekblom-Bak, E. (2018). Long-term effects on cardiovascular risk of a structured multidisciplinary lifestyle program in clinical practice. BMC Cardiovascular Disorders, 18(1), 59. https://doi-org.ezp.waldenulibrary.org/10.1186/s12872-018-0792-6

Marsh, C. C. . P. D., & Rizzo, C., MD. (2019). Hypertension. Magill’s Medical Guide (Online Edition). Retrieved from https://search-ebscohost-com.ezp.waldenulibrary.org/login.aspx?direct=true&db=ers&AN=89093446&site=eds-live&scope=site

Rosendorff, C., Lackland, D. T., Allison, M., Aronow, W. S., Black, H. R., Blumenthal, R. S., … White, W. B. (2015). Treatment of hypertension in patients with coronary artery disease: A scientific statement from the American Heart Association, American College of Cardiology, and American Society of Hypertension. Journal of the American Society of Hypertension, 9(6), 453–498. https://doi-org.ezp.waldenulibrary.org/10.1016/j.jash.2015.03.002

Tada, H., Kawashiri, M., & Yamagishi, M. (2017). Clinical Perspectives of Genetic Analyses on Dyslipidemia and Coronary Artery Disease. Journal of Atherosclerosis and Thrombosis, 24(5), 452-461. https://doi-org.ezp.waldenulibrary.org/10.5551/jat.RV17002

Weber, T., Lang, I., Zweiker, R., Horn, S., Wenzel, R. R., Watschinger, B., . . . Metzler, B. (2016). Hypertension and coronary artery disease: Epidemiology, physiology, effects of treatment, and recommendations. Wiener Klinische Wochenschrift, 128(13-14), 467-479. doi:10.1007/s00508-016-0998-5

 

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Respond on to  two different days who selected different immune disorders and/or factors than you, in the following ways:

Share insights on how the factor you selected impacts the pathophysiology of the immune disorder your colleague selected.

Expand on your colleague’s posting by providing additional insights or contrasting perspectives based on readings and evidence.

 

                                                    Main Post

 

                            Irritable Bowel Syndrome (IBS):

Irritable bowel syndrome is a problem of a bowel function of the gastrointestinal tract.  IBS is one of the most common reasons for gastroenterologist consultation (Hammer & McPhee, 2019).  Irritable bowel syndrome symptoms are persistent abdominal pain, gas, bloating and with bowel disturbance; there are four subtypes of IBS: constipation (IBS-C), diarrhea (IBS-D), mixed (IBS-M), or unsubtyped IBS (IBS-U) (Kosako et al., 2018).  The incidence of IBS is higher in women; it is 1.5 to 3 times higher than men; with greater incidence in youth and middle age (Huether & McCance, 2017).

There is no known pathophysiology of irritable bowel syndrome and no specific biomarker for the disease (Huether & McCance, 2017).  Increasing evidence showed due to the different types of symptoms presentation of IBS that there are possibilities of correlation to altered gut microflora, gut immune responses, neuroendocrine cell function, the brain-gut axis, genetic predisposition and epigenetic factor (Huether & McCance, 2017). Despite the global frequency and disease burden of IBS, its underlying pathophysiology remains unclear (Ng QX et al., 2018).  Inflammation may provide a pathogenic role in IBS; research has shown the occurrence of mucosal irritation at the microscopic and molecular degree in IBS (Ng QX et al., 2018).  It also been reported that considerable overlaps between IBS and inflammatory bowel disease (Ng QX, et al., 2018). 

Psoriasis:

Psoriasis is one of the common issues of chronic skin inflammation. The prevalence of psoriasis affects both sexes and in most ethnic groups (Huether & McCance, 2017).  Most common occurrences are in people in their 30s, but it can also happen soon after birth (Hammer & McPhee, 2019).  Familial history of psoriasis is common, and the genetic process is complicated (Huether & McCance, 2017). 

The inflammatory dynamic of psoriasis involves the multifaceted interaction between macrophages, fibroblasts, dendritic cells, natural killer cells, T helper cells, and regulatory T cells. The influence of these immune cells can signal the secretion of multiple inflammatory mediators such as interferon, tumor necrosis factor-alpha, and various cytokines including interleukin 12, 23 and 17 (Huether & McCance, 2017).  

Maladaptive consequences of IBS and psoriasis:

Skin diseases, including psoriasis, appeared to impact a substantial adverse effect on patients’ health-related quality of life (Jung et al., 2018).  Individuals with psoriasis report that the illness has various physical and mental implications, such as social isolation and stress, depression, shame, and anxiety (Jung et al., 2018).

Patients with irritable bowel syndrome (IBS) have been found to have a significant reduction in quality of life (Arluwaili, et al., 2018). People with IBS report that the disease broth substantial psychosocial consequences such as social lifestyle and activities, emotional, food, and diet interest (Arluwaili, et al., 2018).

Refences

Alruwaili, A. M. M., Albalawi, K. S. A., Alfuhigi, F. R. D., Alruwaili, A. F., Altaleb, B. A. A., & Aljarid, J. S. (2018). Effects of Irritable Bowel Syndrome (IBS) on the health-related quality of Life among Saudi Males at Al-Jouf, Kingdom of Saudi Arabia. Egyptian Journal of Hospital Medicine, 73(4), 6581–6585. Retrieved from https://search-ebscohost-com.ezp.waldenulibrary.org/login.aspx?direct=true&db=a9h&AN=132302964&site=eds-live&scope=site

Hammer, G. D., & McPhee, S. J. (2019). Pathophysiology of disease: An introduction to clinical medicine (8th ed.). New York, NY: McGraw-Hill Education.

Huether, S. E., & McCance, K. L. (2017). Understanding pathophysiology (6th ed.). St. Louis, MO: Mosby.

Jung, S., Lee, S.-M., Suh, D., Shin, H. T., & Suh, D.-C. (2018). The association of socioeconomic and clinical characteristics with health-related quality of life in patients with psoriasis: a cross-sectional study. Health And Quality Of Life Outcomes, 16(1), 180. https://doi-org.ezp.waldenulibrary.org/10.1186/s12955-018-1007-7

Kosako, M., Akiho, H., Miwa, H., Kanazawa, M., & Fukudo, S. (2018). Impact of symptoms by gender and age in Japanese subjects with irritable bowel syndrome with constipation (IBS-C): A large population-based internet survey. BioPsychoSocial Medicine, 12. https://doi-org.ezp.waldenulibrary.org/10.1186/s13030-018-0131-2

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