Volume 101, Issue s41

Irritable bowel syndrome is one of the most commonly encountered functional gastrointestinal disorders, affecting an estimated one in five adult Americans. It is characterized by a symptom complex that includes chronic abdominal pain and discomfort that is relieved with defecation, abnormal stool frequency, and a change in stool form. Although the etiology of this disorder continues to remain elusive, this article reviews the current theory of the pathophysiologic mechanisms and reports on diagnostic and management principles for the primary care provider.

Acute pancreatitis is a relatively common disease with an incidence of 30 per 100,000 persons per year. In the United States, more than 80% of the cases are related to biliary stones or alcohol use. It is a potentially fatal disease with an overall mortality of 5% to 10%. When first seen, patients have an acute abdomen. It is imperative that the diagnosis be established rapidly with a thorough history, physical examination, and appropriate laboratory and imaging studies. Prompt determination of patients who need referral for intensive care or consultation is crucial. There is no specific treatment for most patients with acute pancreatitis. Supportive care includes intravenous administration of fluids, parenterally administered analgesia, nutritional support, and prevention and treatment of complications.

Lactose intolerance affects more than 50 million Americans. It is one of the most common gastrointestinal disorders seen by primary care physicians. When this disorder is properly diagnosed, the patient is easily treated with education and dietary modifications. Lactose intolerance is commonly misdiagnosed because of its overlapping symptoms of diarrhea and abdominal bloating. This article reviews the etiology, diagnosis, and treatment of lactose intolerance.