March 2003: Case Study Two

Pharmacy Times
Volume 0

HG, a criminal defense lawyer, rushes into the Blind Justice Pharmacy during her lunch break. She asks to speak with the pharmacist pertaining to an urgent problem.

HG tells the pharmacist that she has been getting abdominal pains for the last 4 months, and notes that the problem started after she began defending a musician in a high-profile murder trial. She often feels the need to have a bowel movement first thing in the morning. She also notices that the symptoms return during the most stressful moments of the trial.

The pain is often on the left side and can become severe.The pain briefly subsides after she has a bowel movement. Some days her symptoms are accompanied by bloating so severe that she is contemplating adding stretch panels to her skirts. On other days, she experiences nausea.

When asked about her lifestyle, she admits to ?living on coffee? most days. On a good day, she will have time for a hot dog from the cart in front of the courthouse. Her only exercise is running to the bathroom. She has not taken a vacation in 3 years.

The pharmacist asks about the consistency of her stools. HG tells the pharmacist that they are loose and semiformed, but not typically watery. She notices some mucus, but no blood.

HG adamantly insists that the pharmacist give her a diagnosis and a cure. Because the prosecutor had complained to the judge that HG?s frequent trips to the bathroom were a ploy to halt the trial?s progress, the judge had ordered HG to return from lunch with a diagnosis and treatment or she would be held in contempt.

What is the likely diagnosis? What OTC treatment options are available for HG?

Click Here For The Answer ----------->


The likely diagnosis is irritable bowel syndrome (IBS). IBS affects approximately 20% of adults, mostly women. It causes abdominal pain and a change in bowel habits. Although antispasmodics, such as hyoscyamine, are not available without a prescription, HG can try capsules of peppermint oil. Peppermint aids in digestion and has antispasmodic effects. She also can increase her intake of soluble fiber, a bulking agent. Furthermore, HG needs to follow a healthy diet and avoid any foods that aggravate her symptoms. By eliminating caffeine, dairy products, and chocolate from her diet, HG may notice a difference in her symptoms. She will probably claim that she does not have time for it, but relaxation is a key component in relieving her symptoms.

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