Case Study Ibs In Malaysia Real Jinnat


Citation

Satti Osman, Mohamed AbdelGadir (2006) Case study on indusrtialized building system (IBS). Masters thesis, Universiti Putra Malaysia.

Abstract / Synopsis

The construction industry suffers from many problems. The performance of this industry needs to be greatly improved if it so to survive from international competition and increased customer expectations. The building industry which is still very traditional should move towards full industrialization to achieve higher quality, less time and reduce cost. This can be benefited by learning more from manufacturing industry. Industrialised construction methods could be a practical alternative to traditional construction methods for construction projects. Industrialized construction methods are not much used in building projects. In this research three case studies where undertaken. These case studies were companies applying industrializing building systems in their projects. These projects have been conducted in relation with construction and manufacturing process. A number of visits and interviews were held to manufacturing factories of prefabricated components and construction sites and some governmental bodies such as CIDB. This was accomplished by designing a questionnaire and presenting it to a number of people in different positions related to this field. It has been found that manufacturing and prefabrication in building offers a range of potential benefits to those who choose to use them. Quality control and precision can be sustained at a higher level in prefabricated building components due to the controlled factory working conditions and advanced technology available. Other benefits include a reduced number of material deliveries to the job site, resulting in less coordination conflicts among trades. Even though IBS is not new in the Malaysian construction, the usage is still very low compared to conventional methods due to number of problems bordering these methods, and limiting them from expanding. These problems are also studied, and some conclusions and recommendation are given.


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Irritable bowel syndrome (IBS) is one of the most common reasons for visits to the doctor. As a gastroenterologist, it’s impossible to NOT see a patient with IBS symptoms in my clinic every day!

 

My dear patients often come to me with the following: “I have irritable bowel syndrome. What do I do about it? What causes it? Do I need a CT scan or a colonoscopy? How do I fix my leaky gut? Do I need medicine?”

 

IBS is a functional gastrointestinal (GI) disorder characterized by abdominal pain and altered bowel habits in the absence of a specific organic pathology. In other words, there is no structural problem, no tumour or obvious cause. It is estimated that 15% of the population worldwide has IBS, and those affected are mostly under the age of 50. A local university study found a high prevalence of functional constipation among its students (16.2%), with a significantly higher prevalence among women (1).

 

Gastroenterologists apply the Rome IV criteria for the diagnosis of IBS. Patients who have had recurrent abdominal pain – on average at least 1 day per week in the previous 3 months – that is associated with at least 2 of the following:

  • Related to defecation (may be increased or unchanged by defecation)
  • Associated with a change in stool frequency
  • Associated with a change in stool form or consistency

IBS can be subdivided into 4 categories:

  • IBS-D (diarrhea predominant)
  • IBS-C (constipation predominant)
  • IBS-M (mixed diarrhea and constipation)
  • IBS-U (unclassified)

The impact of IBS can range from a mild inconvenience to severe debilitation. Long-term symptoms can disrupt personal and professional activities, and limit an individual’s potential.

No clear answer exists as to what causes IBS. It is believed that the symptoms occur due to abnormal functioning or communication between the nervous system and bowel muscles. Environmental factors – such as changes in routine, diet and infections – can trigger an attack. Stress does not cause IBS, but may trigger its onset or make symptoms worse.

No single test can confirm the diagnosis of IBS. A careful history and physical examination by a gastroenterologist or physician is essential.

Sometimes we need to carry out certain studies to rule out disorders other than IBS:

  • Full blood count to screen for anaemia, inflammation, and infection
  • A comprehensive metabolic panel to investigate metabolic disorders and to rule out dehydration or electrolyte abnormalities in patients with diarrhoea
  • Stool examinations for ova and cysts, enteric pathogens, and Clostridium difficiletoxin

Occasionally, we need specific investigations in difficult cases:

  • Endoscopy (oesophago-gastro-duodenoscopy/colonoscopy) especially in patients with warning signs, or in the elderly
  • Hydrogen breath test to exclude bacterial overgrowth in patients with diarrhoea and screen for lactose intolerance
  • Tissue transglutaminase antibody testing and small bowel biopsy in IBS-D to diagnose celiac disease
  • Thyroid function tests
  • Serum calcium level to screen for hyperparathyroidism

IBS treatment depends on the severity of symptoms. In general, all IBS treatment should start with a gentle explanation about the nature of the disorder:

IBS is a long-term condition. Symptoms can come and go. Symptoms can change over time. The symptoms themselves are not life threatening. IBS is not a risk for cancer or colitis

A dietary diary plays an important role in IBS treatment. Keeping a diary of dietary intake, symptoms, and any associated factors (like daily obligations, stressors, drugs or supplements) for 2-3 weeks can help. Some patients with IBS can benefit from simple dietary modifications by reducing intake of the offending food.

Try taking smaller and frequent meals. Slow down; never rush through meals. Avoid meals that over-stimulate the gut, like “buffet” meals or high fat diet.

The foods most likely to cause problems are: coffee/caffeine/dairy, alcohol, chocolate, nuts, and vegetables e.g. cabbage, cauliflower, onions

Dietary fibre – too much fibre can increase bloating and abdominal pain in some patients, however, eating high fibre foods can help relieve chronic constipation.

Probiotics help improve IBS symptoms. Recent reviews on probiotics have concluded that Bifidobacteria appear to have a beneficial effect in IBS. Probiotics can regulate bowel function including motility, sensation, and immune function.

In addition to the above, stress management, gut-directed hypnosis, biofeedback, and pain management techniques are well also recognised methods to improve symptoms of IBS.

 

People with moderate to severe IBS may benefit from prescribed medication according to the offending symptoms. Laxativescan help to relieve constipation.Anti-diarrhoeal agents, such as loperamide or lomotil,can relieve loose stools. Anticholinergics and antispasmodics have limited benefit for treating IBS. Sometimes, a low-dose antidepressant could be helpful in the patients.

 

Finally, never forget to tell patients with IBS that IBS symptoms can usually be managed to ensure a better quality of life.

 

By Dr. Chieng Jin Yu, Medical Lecturer, Consultant Gastroenterologist and Hepatologist, Universiti Putra Malaysia (UPM).

 

[This article belongs to The Malaysian Medical Gazette. Any republication (online or offline) without written permission from The Malaysian Medical Gazette is prohibited.]

 

References:
1. Ying Jye Lim, Jamaluddin Rosita, Jin Yu Chieng, Abu Saad Hazizi. The Prevalence and Symptoms Characteristic of Functional Constipation Using Rome III Diagnostic Criteria among Tertiary Education Students. PLoS ONE 11(12): e0167243.

  1. Irritable Bowel Syndrome / IBS Health Center – WebMD

 

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