Sarah Blankenship
2/12/12
General Medical Conditions
Gastrointestinal Disorders
Irritable Bowel Syndrome
1. IBS is a common chronic condition of unknown cause, most typically starting in people below
the age of 35 years. IBS is a disorder of gastrointestinal motility with abnormal cycles of muscle
contraction and relaxation.
2. Some people may have
a. Predominantly diarrhea
b. Constipation-predominant type
c. Some have diarrhea alternating with constipation
d. Abdominal bloating
e. Generalized discomfort
f. Diffuse abdominal pain, with or without fecal urgency
g. Occasional mucus mixed with stool or abdominal distention and nausea
3. Treatment
a. Management of IBS consists of ongoing reassurance to the patient and supportive
encouragement, as there are no agents shown to control all symptoms. The best
responses seem to come from constant vigilance toward a high-fiber diet and stress
management.
4. Medications
a. Diarrhea and constipation can each be managed with OTC medicine.
b. Prescription antispasmodic medicines (Dcyclomine)
5. The athlete with IBS can fully participate in sports depending on the severity of symptoms.
Although some athletes my cope better with symptoms during critical games or performances,
others may become incapacitated at these times. Professional assessment and management of
stress, including techniques such as biofeedback, can be very helpful for these athletes.
Cuppett, M., & Walsh, K. M. (2012). General medical conditions in the athlete. (2nd ed., pp. 187).
Mosby.
Appendicitis
1. Is caused by an acute obstruction an inflammation of the appendix
2. Signs and Symptoms
a. Diffuse epigastric or periumbilical pain early
b. Pain localization to the right lower quadrant within 12 to 18 hours
c. Point of maximal tenderness at McBurney’s point
d. Low-grade fever
e. Nausea or vomiting
3. Treatment
a. Surgery and removal of the appendix. (appendectomy)
4. Medication
a. N/A
5. Participation
a. The time in of the return to participation is best deferred to the surgeon. It depends on
the sport in question, the type of surgical procedure (open or laparoscopic), and the
extent of potential surgical complications.
Cuppett, M., & Walsh, K. M. (2012). General medical conditions in the athlete. (2nd ed., pp. 187-188).
Mosby.
Cholecystitis
1. Is inflammation of the gallbladder and most commonly caused by gallstone, or cholelithiasis.
2. Signs and symptoms
a. Intermittent Right Upper Quadrant pain
b. Nausea
c. Vomiting
d. Indigestion
e. Symptoms are worse after eating a high-fat meal
f. Tenderness in the RUQ
g. Murphy’s Sign (sudden stopping or arrest of inspiration when examiner deeply palpates
the liver while the patient takes a deep breath)
3. Treatment
a. Callstone and cholecystitis are treated surgically by removal of the gallbladder
(cholecystectomy).
4. Medication
a. N/A
5. Participation
a. Return to play after sugery depends on the type of surgery, and the decision is best left
to the surgeon. For many patients, however, the symptoms of gallstones may be fairly
mild and intermittent and the patient can simply remain on a very low-fat diet to get
through the season and have elective surgery after the season.
Cuppett, M., & Walsh, K. M. (2012). General medical conditions in the athlete. (2nd ed., pp. 189).
Mosby.
Crohn’s disease
1. Crohn's disease is a form of inflammatory bowel disease (IBD). It usually affects the intestines,
but may occur anywhere from the mouth to the end of the rectum (anus).
2. Signs and symptoms
a. Symptoms depend on what part of the gastrointestinal tract is affected. Symptoms
range from mild to severe, and can come and go with periods of flare-ups.
b. The main symptoms of Crohn's disease are:
i. Crampy abdominal (belly area) pain
ii. Fever
iii. Fatigue
iv. Loss of appetite
v. Pain with passing stool (tenesmus)
vi. Persistent, watery diarrhea
vii. Unintentional weight loss
c. Other symptoms may include:
i. Constipation
ii. Eye inflammation
iii. Fistulas (usually around the rectal area, may cause draining of pus, mucus, or
stools)
iv. Joint pain
v. Liver inflammation
vi. Mouth ulcers
vii. Rectal bleeding and bloody stools
viii. Skin lumps or sores (ulcers)
ix. Swollen gums
3. Treatment
a. Diet and Nurtrition
i. Certain types of foods my worsen diarrhea and gas symptoms. The problem is
more likely during periods when symptoms are present. Possible changes you
can make to your diet include:
1. Eat small abounts of food throughout the day
2. Drink lots of water (drink small amounts often throughout the day)
3. Avoid high-fiber foods (bran, beans, nuts, seeds, and popcorn)
4. Avoid fatty, greasy or fried foods and sauces (butter, margarine, and
heavy cream).
5. Avoid fatty, greasy or fried foods and sauces (butter, margarine, and
heavy cream).
6. If your body does not digest dairy foods well, limit dairy products. Try
low-lactose cheeses, such as Swiss and cheddar, and an enzyme
product, such as Lactaid, to help break down lactose.
7. Avoid foods that you know cause you gas, such as beans, spicy food,
cabbage, broccoli, cauliflower, raw fruit juices and fruits -- especially
citrus fruits
ii. People who have a blockage of the intestines may need to avoid raw fruits and
vegetables and other high-fiber foods.
iii. Ask your doctor about extra vitamins and minerals you may need:
1. Iron supplements (if you are anemic)
2. Calcium and vitamin D supplements to help keep your bones strong
3. Vitamin B12 to prevent anemia
4. Medication
a. You can take medication to treat very bad diarrhea. Loperamide (Imodium) can be
bought without a prescription. Always talk to your doctor or nurse before using these
drugs.
b. Other medicines to help with symptoms include:
i. Fiber supplements may help your symptoms. You can buy psyllium powder
(Metamucil) or methylcellulose (Citrucel) without a prescription. Ask your
doctor about these products.
ii. Always talk to your doctor before using any laxative medicines.
iii. You may use acetaminophen (Tylenol) for mild pain.
iv. Drugs such as aspirin, ibuprofen (Advil, Motrin), or naproxen (Aleve, Naprosyn)
may make your symptoms worse.
c. Your doctor may also give you a prescription for stronger pain medicines.
d. Medicines that may be prescribed include:
i. Aminosalicylates (5-ASAs) are medicines that help control mild to moderate
symptoms. Some forms of the drug are taken by mouth; others must be given
rectally.
ii. Corticosteroids (prednisone and methylprednisolone) are used to treat
moderate to severe Crohn's disease. They may be taken by mouth or inserted
into the rectum.
iii. Medicines such as azathioprine or 6-mercaptopurine quiet the immune system's
reaction.
iv. Antibiotics may be prescribed for abscesses or fistulas.
v. Biologic therapy is used to treat patients with severe Crohn's disease that does
not respond to any other types of medication. Medicines in this group include
Infliximab (Remicade) and adalimumab (Humira), certolizumab (Cimzia), and
natalizumab (Tysabri).
5. The athlete with Crohn’s disease can fully participate in sports depending on the severity of
symptoms. Although some athletes my cope better with symptoms during critical games or
performances, others may become incapacitated at these times.
Longstreth, M.. "Crohn’s disease." Pubmed health. A.D.A.M. Medical Encyclopedia, 2010. Web. 11 Feb
2012.
Colitis
1. Colitis is swelling (inflammation) of the large intestine (colon).
2. Signs and Symptoms
a. Abdominal pain and bloating that is constant or comes and goes
b. Bloody stools
c. Chills
d. Constant urge to have a bowel movement
e. Dehydration
f. Diarrhea
g. Fever
3. Treatment
a. Treatment is directed at the cause of disease (infection, inflammation, lack of blood
flow, or another cause).
4. Medication
a. N/A
5. Participation
a. The athlete with colitis can fully participate in sports depending on the severity of
symptoms. Although some athletes my cope better with symptoms during critical
games or performances, others may become incapacitated at these times
Adam, 2009. N.p., 2009. Web. 11 Feb 2012.
<http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002112/>.
Esophageal reflux
1. A common condition caused by stomach acid leaking through the lower esophageal sphincter
into the esophagus and/or the throat.
2. Signs and symptoms:
a. Heartburn
b. Chest pain, potentially severe
c. Belching
d. Regurgitation of food and stomach acid
e. Chronic cough
f. Laryngitis
g. Asthmatic attacks in those with asthma
h. In patients with chronic conditions, lasting years, esophageal damage may occur
i. Increased risk for esophageal cancer
3. Treatment options
a. Usually targeted towards proper lifestyle management
i. Avoiding foods that trigger symptoms
b. Over the counter medications
c. Prescription medications
4. Medication
a. Antacids (OTC)
i. Maalox
ii. Mylanta
iii. Rolaids
iv. Tums
b. H2 blockers (OTC)
i. Tagamet HB
ii. Pepcid AC
iii. Zantac
c. Proton pump inhibitor (Prescription)
i. Prilosec
5. Athletic Participation
a. Acid related disorders are rarely severe enough to affect athletic activity.
b. Athletes should avoid eating within 3 hours of activity.
6. Cuppett, M., & Walsh, K. M. (2012). General medical conditions in the athlete. (2nd ed., pp.
189). Mosby.
Gastritis
1. A diffuse or patchy inflammation of the stomach.
2. Signs and symptoms
a. Mild to moderate persistent mid-abdominal pain
b. Loss of apetite
c. Nausea
d. Pain aggravated by eating
e. Gastrointestinal bleeding
f. Black, tarry stool
g. Blood with vomiting
3. Treatment options
a. OTC medications
b. Physician check ups
4. Medication
a. Antacids (OTC)
i. Maalox
ii. Mylanta
iii. Rolaids
iv. Tums
b. H2 blockers (OTC)
i. Tagamet HB
ii. Pepcid AC
iii. Zantac
c. Proton pump inhibitor (Prescription)
i. Prilosec
5. Athletic Participation
a. Symptoms will rarely interfere with athletic activity and the athlete should be able to
participate in all sports. However, athletes should avoid activities that trigger symptoms.
6. Cuppett, M., & Walsh, K. M. (2012). General medical conditions in the athlete. (2nd ed., pp.
186). Mosby.
Indigestion:
1. Indigestion — also called dyspepsia or an upset stomach — is a general term that describes
discomfort in your upper abdomen. Indigestion is not a disease, but rather a collection of
symptoms you experience, including bloating, belching and nausea. Although indigestion is
common, how you experience indigestion may differ from other people. Symptoms of
indigestion might be felt occasionally or as often as daily.
2. Signs and Symptoms:
a. Early fullness during a meal. You haven't eaten much of your meal, but you already feel
full and may not be able to finish eating.
b. Uncomfortable fullness after a meal. Fullness lasts longer than it should.
c. Pain in the upper abdomen. You feel a mild to severe pain in the area between the
bottom of your breastbone (sternum) and your navel.
d. Burning in the upper abdomen. You feel an uncomfortable heat or burning sensation
between the bottom of the breastbone and navel.
e. Nausea. You feel like you are about to vomit.
f. Bloating. Your stomach feels swollen, tight and uncomfortable.
g. Unintentional weight loss or loss of appetite
h. Repeated vomiting or vomiting with blood
i. Black, tarry stools
j. Yellow coloring in the skin and eyes (jaundice)
k. Trouble swallowing that gets progressively worse
l. Shortness of breath, sweating or chest pain radiating to the jaw, neck or arm
m. Chest pain on exertion or with stress
3. Treatment Options:
a. If lifestyle changes — especially avoiding offending foods — don't help your indigestion,
there also are over-the-counter and prescription medications that may help. Most are
designed to reduce stomach acid or help move food from the stomach to the small
intestine.
4. Medication Options:
a. Antacids
i. Alka-Seltzer
ii. Maalox
iii. Mylanta
iv. Tums
b. H-2-receptor antagonists (H2RAs)
i. Axid
ii. Tagamet
iii. Pepcid
iv. Zantac,
c. Proton pump inhibitors (PPIs)
i. Aciphex
ii. Nexium
iii. Prevacid
iv. Prilosec
v. Protonix
vi. Zegerid
vii. Prilosec
viii. Prevacid
d. Prokinetics
i. Reglan
e. Antibiotics
i. If the bacteria that causes peptic ulcer disease (Helicobacter pylori) is causing
your indigestion, your doctor may prescribe an antibiotic.
f. Antidepressants
i. If a thorough evaluation doesn't reveal a cause for your symptoms and the
conventional treatments listed above don't work, your doctor may recommend
an antidepressant medication. These prescription medications may improve the
discomfort from indigestion by decreasing your sensation of pain.
5. Indigestion can cause an athlete to become nauseated or have gas. This can slow the athlete
down in practice and make them not want to practice. If the athlete takes some medicine the
symptoms should go away.
6. http://www.mayoclinic.com/health/indigestion/DS01141/DSECTION=treatments-and-drugs
Ulcer:
1. Peptic ulcers are open sores that develop on the inside lining of your esophagus, stomach and
the upper portion of your small intestine.
2. Signs and Symptoms:
a. Pain is the most common symptom. Burning pain is the most common peptic ulcer
symptom. The pain is caused by the ulcer and is aggravated by stomach acid coming in
contact with the ulcerated area.
b. Be felt anywhere from your navel up to your breastbone
c. Be worse when your stomach is empty
d. Flare at night
e. Often be temporarily relieved by eating certain foods that buffer stomach acid or by
taking an acid-reducing medication
f. Disappear and then return for a few days or weeks
g. The vomiting of blood — which may appear red or black
h. Dark blood in stools or stools that are black or tarry
i. Nausea or vomiting
j. Unexplained weight loss
k. Appetite changes
3. Treatment Options:
a. Treatment for peptic ulcers typically involves antibiotics to kill the H. pylori bacterium
and other medications to reduce the level of acid in your digestive system to relieve
pain and encourage healing. You may take antibiotics for two weeks and acid-reducing
medications for about two months.
b. If your peptic ulcer isn't caused by H. pylori, you won't need antibiotics. Instead, your
doctor may recommend treatments for your specific situation. For instance, if pain
relievers caused your ulcer, your doctor may recommend a different pain reliever or a
different dose. Your doctor may also recommend acid-reducing medications to allow
your ulcer to heal. You may take these medications for two months or more.
4. Medication Options:
a. Antibiotic medications to kill H. pylori.
i. Amoxicillin
ii. clarithromycin (Biaxin)
iii. metronidazole (Flagyl)
iv. tetracycline
b. Medications that block acid production and promote healing.
i. omeprazole (Prilosec)
ii. lansoprazole (Prevacid)
iii. rabeprazole (Aciphex)
iv. esomeprazole (Nexium)
v. pantoprazole (Protonix)
5. An athlete can participate because symptoms rarely interfere with the athlete’s ability to play.
6. http://www.mayoclinic.com/health/peptic-ulcer/DS00242/DSECTION=treatments-and-drugs