DorlandHealth

A Controversy That Care Managers Should Know About

PART I

This is the first of a two-part series about cardiovascular risk, identifying people with those risks, and helping them lower it — and importantly, what role care managers can play in that effort. In part one, we present the statistics on cardiovascular risk and define an actor — metabolic syndrome — that started an ongoing controversy in the medical community. In part two, we will describe how different areas of the medical community have disagreed with the definition and focus of the condition, and how this lack of consensus may be affecting a concerted effort to decrease cardiovascular risk. We also focus on how care managers can respond to the needs of the patient in the face of the controversy — helping them identify and decrease their cardiovascular risks and improve quality of life while, at the same time, the medical community clarifies the evidence.

Look around. In malls, on bleachers at ball games, in offices, at family dinners. Every place you go, you will find us. We are young and old, male and female, from every ethnic group, and we look like a cross-section of America. We are busy living our lives, going to work, taking care of our families. We feel well, and many of us consider ourselves healthy. But the truth is there are those among us who are “walking cardiovascular time-bombs.” And in many cases, we don’t even know it — until it’s too late.

The statistics on cardiovascular disease in America aren’t pretty. Coronary heart disease (CHD) is the largest major killer of both American males and females, causing one in five deaths in the U.S. Every 25 seconds an American suffers a coronary event, and every minute one of us dies from it, according to statistics from the American Heart Association (AHA). This year, approximately 785,000 Americans will experience a new coronary attack, 470,000 will have a recurrent one, and an additional 195,000 will have a silent event. 

Three fallout effects when the complex digestive circuit falls from a state of balance. Exploring irritable bowel syndrome, diverticular disease and pancreatitis.

Historically, the gastrointestinal tract has been taken for granted. In fact, our collective gastrointestinal tracts have been much abused — we see a food or drink, we want it, we ingest it, and we expect to digest it without incident. Only when this highly sensitive set of organs decides to rebel do we acknowledge their existence, and realize that we should be nurturing them as steadfastly as any other organ set in our bodies.

What You See Isn’t What You Get

The most common affliction affecting the gastrointestinal tract, and the most frequent reason patients visit the gastroenterologist’s office is irritable bowel syndrome (IBS). A functional bowel disorder and a symptomatic disease process without an underlying structural cause, it is a chronic, episodic condition characterized by abdominal pain and alternating bowel function that flips between constipation and diarrhea. Although the exact causes of IBS remain obscure, the most common theory is that it is caused by a miscommunication between the brain and the gastrointestinal tract. Medical conditions commonly associated with IBS include headaches, depression, inflammatory bowel disease (IBD), and endometriosis.