Patients’ Experience of Living with Irritable Bowel Syndrome (IBS): A Hermeneutic Phenomenology

Introduction: Irritable bowel syndrome (IBS) is a chronic gastrointestinal disorder with a wide range of effects on the individual’s quality of life, emotional state, and identity. Given the lack of knowledge about patients’ perceptions of life with irritable bowel syndrome, this study aimed to describe and interpret patients' experience of living with irritable bowel syndrome Methods: The present qualitative study was conducted using a hermeneutic phenomenological approach on 15 patients with irritable bowel syndrome who referred to three central clinics. The data were collected through in-depth semistructured interviews with the participants who were selected through purposive sampling. Thematic analysis was carried out using Van Manen’s six-step methodological framework as a guide. Besides, MAXQDA software was used for data management. Results: The analysis of the data yielded four themes and eight subthemes. The patients’ experiences of living with IBS were manifested through the themes of “crisis and transient release” (with “storm in the corporeality” and “relief” subthemes); “surrender and harassment” (with “mandatory submitting” and “feeling of helplessness” subthemes); “looking for adaptation” (with “struggle in obtaining insight” and “seeking help from coping strategies” subthemes); and “different selfperceptions” (with “threatened self” and “deep self-knowledge” subthemes). Conclusion: Understanding the life experience of IBS patients can be effective in improving the interdisciplinary medical-care programs and reducing their psychological, social, and physical problems. Therefore, carrying out more studies to promote the quality of life of IBS patients is suggested

Experience lived by iranian patients with Irritable Bowel Syndrome: transitory Crisis and Liberation

Objective. Research on the nature of living with Irritable Bowel Syndrome. Methods. Qualitative study of the hermeneutical phenomenology, which conducted in-depth semi-structured interviews with people trained on the irritable bowel syndrome. The sampling was intentional type and open questions were used to collect data. The Thematic Analysis Method by Van Manen was used. Results. Two principal themes and five subthemes emerged in this research to determine the meaning of living with the irritable bowel syndrome: Storm in corporality (body with pain and affliction, tension and sequence of symptoms, and: distress during moments of life) and Relief (sense of liberation of the body symptoms, and moments with pleasure). Conclusion.The experience lived by patients with irritable bowel syndrome is of a transitory crisis and liberation.Objetivo. Investigar a natureza de viver com a Síndrome do Intestino Irritável. Métodos. Estudo qualitativo da fenomenologia hermenêutica na qual se realizaram entrevistas semiestruturadas em profundidade a pessoas com diagnóstico de síndrome do intestino irritável. A amostragem foi de tipo intencional e se utilizaram perguntas abertas para recopilar os dados. Se empregou o método de análises temático de Van Mennen. Resultados. Dois temas principais e cinco subtemas emergiram na presente investigação para determinar o significado de viver com a Síndrome do Intestino Irritável: Tormenta na corporalidade (corpo com dor e aflição, tensão e sequência de sintomas, e: angustia nos momentos da vida) e Alívio (sensação de liberação dos sintomas corporais, e momentos com prazer). Conclusão. A experiência vivida de pacientes com síndrome do intestino irritável é de uma crises transitórias e liberaçãoObjetivo. Conocer la experiencia de vivir con el Síndrome del Intestino Irritable. Métodos. Estudio cualitativo de la fenomenología hermenéutica en el que se realizaron entrevistas semiestructuradas en profundidad a personas con diagnóstico de síndrome del intestino irritable. El muestreo fue de tipo intencional y se utilizaron preguntas abiertas para recopilar los datos. Se empleó el método de análisis temático de Van Mennen. Resultados. Dos temas principales y cinco subtemas emergieron en la presente investigación para determinar el significado de vivir con este síndrome: Tormenta en la corporalidad (cuerpo con dolor y aflicción, tensión y secuencia de síntomas, y: angustia en los momentos de la vida) y Alivio (sensación de liberación de los síntomas corporales, y momentos con placer). Conclusión. La experiencia vivida de pacientes con síndrome del intestino irritable es de una crisis transitoria y de liberación

Patients’ experience of living with irritable bowel syndrome (IBS): A hermeneutic phenomenology

Introduction: Irritable bowel syndrome (IBS) is a chronic gastrointestinal disorder with a wide range of effects on the individual’s quality of life, emotional state, and identity. Given the lack of knowledge about patients’ perceptions of life with irritable bowel syndrome, this study aimed to describe and interpret patients' experience of living with irritable bowel syndrome Methods: The present qualitative study was conducted using a hermeneutic phenomenological approach on 15 patients with irritable bowel syndrome who referred to three central clinics. The data were collected through in-depth semi-structured interviews with the participants who were selected through purposive sampling. Thematic analysis was carried out using Van Manen’s six-step methodological framework as a guide. Besides, MAXQDA software was used for data management. Results: The analysis of the data yielded four themes and eight subthemes. The patients’ experiences of living with IBS were manifested through the themes of “crisis and transient release” (with “storm in the corporeality” and “relief” subthemes); “surrender and harassment” (with “mandatory submitting” and “feeling of helplessness” subthemes); “looking for adaptation” (with “struggle in obtaining insight” and “seeking help from coping strategies” subthemes); and “different self-perceptions” (with “threatened self” and “deep self-knowledge” subthemes). Conclusion: Understanding the life experience of IBS patients can be effective in improving the interdisciplinary medical-care programs and reducing their psychological, social, and physical problems. Therefore, carrying out more studies to promote the quality of life of IBS patients is suggested

Self-Perception of Iranian Patients during their life with Irritable Bowel Syndrome: A Qualitative Study

Background: Irritable bowel syndrome (IBS), as a chronic digestive disorder, impacts extensively on the quality of life, emotional well-being and self-identity. Chronic illness disrupts taken-for-granted notions about self. No qualitative study was found regarding patients’ experience of life with irritable bowel syndrome (IBS) in Iran. Objective: To explore the self-perception of lived experience of IBS patients. Methods: A qualitative study with hermeneutic phenomenological approach was conducted on 12 IBS patients who had been referred to three central clinics (2 governmental and 1 private) affiliated to Shiraz University of Medical Sciences. The data were collected through in-depth semi-structured interviews from July 2015 to September 2016 by purposeful sampling. Thematic analysis was carried out using Van Manen’s six-step methodological framework as a guide. In addition, MAXQDA software was used for data management. Results: In this study, two main themes “the threatened self” and “deep self-knowledge”, emerged during the life of patients with IBS, indicating the meaning of self-perception of such patients. The theme of “the threatened self” consisted of two subthemes of “fear from stigmatization” and “bad sense of self”. The subthemes of “body knowledge”, “self-acceptance” and “personal growth” were related to deep self-knowledge. Conclusion: The results of the present study could be applied in designing and implementation effective and holistic care of IBS patients

A challenging case of carbapenem resistant Klebsiella pneumoniae-related pyogenic liver abscess with capsular polysaccharide hyperproduction: a case report

Abstract Background Carbapenem-resistant Klebsiella pneumoniae (CRKP) infections are a major public health problem, necessitating the administration of polymyxin E (colistin) as a last-line antibiotic. Meanwhile, the mortality rate associated with colistin-resistant K. pneumoniae infections is seriously increasing. On the other hand, importance of administration of carbapenems in promoting colistin resistance in K. pneumoniae is unknown. Case presentation We report a case of K. pneumoniae-related pyogenic liver abscess in which susceptible K. pneumoniae transformed into carbapenem- and colistin-resistant K. pneumoniae during treatment with imipenem. The case of pyogenic liver abscess was a 50-year-old man with diabetes and liver transplant who was admitted to Abu Ali Sina Hospital in Shiraz. The K. pneumoniae isolate responsible for community-acquired pyogenic liver abscess was isolated and identified. The K. pneumoniae isolate was sensitive to all tested antibiotics except ampicillin in the antimicrobial susceptibility test and was identified as a non-K1/K2 classical K. pneumoniae (cKp) strain. Multilocus sequence typing (MLST) identified the isolate as sequence type 54 (ST54). Based on the patient’s request, he was discharged to continue treatment at another center. After two months, he was readmitted due to fever and progressive constitutional symptoms. During treatment with imipenem, the strain acquired bla OXA−48 and showed resistance to carbapenems and was identified as a multidrug resistant (MDR) strain. The minimum inhibitory concentration (MIC) test for colistin was performed by broth microdilution method and the strain was sensitive to colistin (MIC < 2 µg/mL). Meanwhile, on blood agar, the colonies had a sticky consistency and adhered to the culture medium (sticky mucoviscous colonies). Quantitative real-time PCR and biofilm formation assay revealed that the CRKP strain increased capsule wzi gene expression and produced slime in response to imipenem. Finally, K. pneumoniae-related pyogenic liver abscess with resistance to a wide range of antibiotics, including the last-line antibiotics colistin and tigecycline, led to sepsis and death. Conclusions Based on this information, can we have a theoretical hypothesis that imipenem is a promoter of resistance to carbapenems and colistin in K. pneumoniae? This needs more attention

Frequency of Different Psychiatric Disorders in Patients With Functional Bowel Disorders: A Short Report

Background Functional gastrointestinal (GI) disorders are very common and many patients with such disorders are not satisfied with treatment outcomes. Psychological aspects of functional disorders need special attention that may play an important role in patient management. Objectives In this study, psychology evaluation was performed for a population of patients with functional bowel disorders. Patients and Methods One hundred patients with functional bowel disorders including 50 patients with irritable bowel syndrome (IBS) referred to GI clinics were candidates for psychiatry evaluation; of those 60 patients completed the study. Psychiatric disorders were diagnosed using a structured clinical interview based on diagnostic and statistical manual of mental disorders IV (DSM IV). Results Of 60 patients with functional bowel disorders (including 39 IBS), 51 (85%) were diagnosed with at least one psychiatry disorder. The most common disorders were dysthymia (25%) and obsessive-compulsive disorder (20%). There was no significant difference between IBS patients and other functional bowel disorders regarding the prevalence of psychiatric disorders. Conclusions Psychiatric disorders are very prevalent among patients with functional bowel disorders. Prompt diagnosis and appropriate management of associated psychiatric disorders along with GI targeted treatments may lead to a better outcome in these patients

The Antioxidant and Anti-Inflammatory Effects of Quercus brantii Extract on TNBS-Induced Ulcerative Colitis in Rats

Objectives. Ulcerative colitis is a common subtype of persistent inflammatory bowel disease with high morbidity consequences. Despite unknown definite pathogenesis, multiple anti-inflammatory medications are used for its treatment. Traditionally, Quercus brantii (QB), mostly available in the Middle East, has been used for gastrointestinal disorders. Other beneficial effects associated with QB include reduction of oxidative stress, inflammations, homeostatic instability, and improvement in clinical conditions. Materials and Methods. This experimental study was designed to assess the possible therapeutic effects of QB on UC and compare its effects with those of sulfasalazine. Of the 70 Wistar rats clustered in seven groups, ten received only alcohols and sixty were confirmed to be suffering from trinitrobenzene sulfonic acid- (TNBS-) induced colitis. Four groups received different dosages of QB extract via oral and rectal routes, one received sulfasalazine, and the other remaining two groups received nothing. The effects of QB were evaluated by assessing macroscopic and histologic scoring, measuring inflammatory mediators, and determining oxidative stress markers. Results. Comparing to the untreated TNBS-induced control groups, QB-treated groups showed a dose- and route-dependent improvement comparable with sulfasalazine. Treating rats with QB reduced the microscopic and macroscopic damage, decreased TNF-α, IL-6, NO, MPO activity, and MDA content, increased superoxide dismutase (SOD) activity, and reduced body weight loss. Conclusions. Our data recommended the anti-inflammatory and antioxidant effects of QB extract in a dose-dependent manner