Irritable Bowel Syndrome IBS and What Tests You Should Get
Kenneth Falchukgt;gt;gt; Irritable bowel syndromeis the word points to it, is a syndrome, it is a composite of complaints that patientshave that effect the GI tract. It is not something that we could immediately say is caused byan infection or is caused by a structural change in the bowel. So therefore the physician who evaluates thepatient with irritable bowel syndrome (IBS) has to pay attention to the types of symptoms,when they occuré How frequent is your trigger factor, has to evaluate his patient for thepossibility of other conditions and that is where we bring in the criteria of or the charactersof what we call reg flags.
So irritable bowel syndrome is a combinationof symptoms that the patient mentions to the treating evaluating physician that consistsof either pain with or without a change in bowel habit such as diarrhea, constipation,or a variable pattern, a mixture of both diarrhea or constipation with bloating with a changein a shape, consistency of they stools, they could be loose, they could be hard, they couldbe like little fragments. Above all, the irritable bowel does not havethe red flags that I mentioned previously, that is the presence of bleeding, very significantrelevant weight loss in a short period of time, no fever, and no vomiting, once we considerthe red flags and if they are not present
in the patient, there are other lab resultsthat we could request to evaluate the patient and exclude something that may be caused byanother illness other than the IBS, the irritable bowel. If a physician requests those labs, they arenot specific. There is no specific blood test to make the diagnosis of an irritable bowel.So what one does when he looks at the lab for help to see if there is anemia, evidenceof bleeding indirectly or directly, a low red cell count, a low iron or something calledferritin, signs of inflammation in the blood. We request a test called Sed rate or CRP thatindirectly look at this aspect.
Other tests may show low protein to suggesta difficult absorption, nutrition, which is not really a main issue when one deals withirritable bowel. So once the red flags are excluded and that the physician is certainabout that, he or she can then say â€œWell I am not yet sure. I need to evaluate my patientproperly.â€� That can be done with xrays such as CAT scan, xray of a small intestine,a barium enema sometimes or proceed to something more specific and definitive, yet somewhatinvasive called a colonoscopy where you look at the lining of the colon. You can take samplesand make sure there is no inflammation. The bottomline is to make sure that thereis no colitis because colitis is treated differently.
It is somewhat of a greater concern to somepatients because it could bleed to serious consequences and disabilities, so it is importantnot to attach diagnosis of IBS, irritable bowel, to someone who may have something thatcan be treated differently and therefore modify their quality of life and outcome. I think that more or less summarizes whatI have been trying to convey about what IBS irritable bowel syndrome is and how to proceedwith a detail specific evaluation of this condition.
Cpa in Reno Our CPA in Reno does Fraud Classifications 7758256008
so this uh. table that we're lookingat is a classification system to help uh. accountants and forensic uh.investigators determine how a fraud actually took place kindadivided into three different categories one is corruption corruption usually involves the uh. bribery or uh. illegal kickbacks etc uh. you know involving outside partytheir customer or vendors helping you commit fraud against an organization the second one the most frequently is aasset misappropriation so the stealing
of cash or other assets of anorganization uh. and then the last category lastmajor categories the financial statement fraud and that references the alargescale misstatement of financial statements like you saw in theenron and worldcom case uh. as we go down through i'm uh.the corruption cases can talk about a conflict of interest where you reallyshouldn't have been doing meaning you have a responsibility as apurchasing agent and you make a deal
with the vendors to give you a free tripto hawaii if you buy the stuff to them even if the prices isn't as good uh. bribery bribery actually is a truekickback scenario where uh. i you know if in exchange for buying abunch of my stuff whatever it is i give you actual cash payments and so on and so forth in the asset misappropriation category they can beother types of assets the stealing of inventory or computers with that kind ofthing or more frequently we see it in
cash again this is the vast majority ofthe actual theft of cash and can actually be uh. the actual theft of cash on handin cash based businesses bars and things like that that can be at the theft of cashreceipts where customer makes a payment the AR is changed in the systemand the actual payment is uh. pocketed by the your perpetratoruh. or in the fraudulent disbursements so where an office manager for examplemight be forging checks or of you
know taking other type ofdisbursements the last classification and the highest dollar amount although the frequency of incidences the financialstatement fraud and that usually is by uh. faking up the financial statementsto make them look better by uh. overstating revenue or overstatingassets or understating liabilities or understating expenses so that's generally the classification of frauds that take placeuh. internationally.
Taiwan Ascension Conference Report By Cobra
I greet you in the love and the light of theinfinite Creator. Taiwan Ascension Conference Report. By, Cobra.Our Ascension conference was taking place in Taipei, the home base of many positiveDragon groups. The Blue, the White and the Black were together with us at the conferenceand the Plum were aware of our presence. Our group was strong and focused and our physicaland nonphysical support team was more effective than ever and a certain breakthrough happenedon the nonphysical planes which indicates that the Veil will disintegrate ï¿½soonï¿½. The opening in the Veil can be seen energeticallyon this picture of pink sky in Taipei which
was taken a few days after the conference: A certain cycle was completed and we are enteringthe next phase of the Breakthrough process where things will escalate towards the CompressionBreakthrough. More intel about this will be released in the near future, as will intelabout surrender negotiations. Just a few hours before the beginning of theconference, a military coup happened in Turkey. The coup was carried out by the Positive Militaryin Turkey against Erdogan and was crushed by the US negative military faction as instructedby their Khazarian Jesuit commanders. Although the coup failed, it has elevated the geopoliticalendgame to a totally new level that will lead
towards the recognition of the factions thatdestabilize the Middle East. This will lead to resolution of all military conflicts worldwideand towards planetary peace at the moment of the Compression Breakthrough. This is what I have received on the day afterthe coup about the situation in Turkey from a reliable intel source from Middle East: ï¿½The coup was carried out by 60% of theTurkish army, including staff of the air force and even the reserve soldiers came out tothe streets to support their colleagues against the dictatorship of Erdogan .
The army tanks entered to the streets in Ankaraand Istanbul, the largest Turkish cities, flying army helicopters carrying army personneltaking command of vital infrastructure centers to control them and that was successfullyaccomplished. Successful control of the TV broadcast building, Ataturk InternationalAirport and the houses of Parliament and the Presidential Palace where Erdogan was, whowas taken by military helicopter to the Ankara international airport where he asked to leavethe country immediately . Erdogan approved the demands of the coup leadersunder condition of preservation of his life and the lives of his family and he was grantedthis condition. Then he recorded a Skype voice
message on board of the airplane asking supportersof his efforts to go out to the streets to stop this coup . No one went out to the streets during thewee hours of the coup and the scene was blurry, those supporting this coup were by the thousandsmarching next to army tanks greeting the soldiers raising the banner of Turkey and referringto the founder of modern Turkey Mustafa Ataturk . What happened afteré Erdogan flew from Ankara airport out of thecountry and he asked for asylum to Germany
but Germany refused, then to Azerbaijan whichclosed its borders and so did Iran in the face of Erdogan. Erdogan had no choice but to return. A phonecall between Obama and Erdogan took place in the plane as stated in the Washington Post,and he asked and was given permission to land in Incirlik US military base in the southof Turkey. Moments after that, 12 unknown F16 aircraftin the skies of Ankara and Istanbul intercepted and shot down 25 helicopters of the Turkisharmy, carrying soldiers and some leaders who were on their way to control the vital centersin the country, and a real war took place