10: Adult IBS Flashcards
3 types of IBS.
- Constipation dominant
- Diarrhea dominant
- Abd pain/bloating dominant
Where would complaints of pain be expected in IBS?
Lower levels of intestines
5 ways to treat diarrhea dominant IBS?
- Stress reduction
- Dietary modification
- Fiber supplementation
- Antidiarrheal medications such as loperamide or diphenoxylate can be considered, but use sparingly
- Antispasmodics such as hyoscyamine (sl) or dicyclomine
T/F Irritable bowel syndrome (IBS) is a diagnosis of exclusion.
True. Nothing else on workup is significant.
ROME criteria for IBS.
- Pt must have abd pain or discomfort 3+ days/month in last consecutive 3 months
- 2 or more:
- Improvement of pain with defecation
- Onset associated with change in frequency of stooling
- Onset associated with change in appearance of stool
Diagnostics in IBS.
- CBC
- TSH
- Stool for O and P
- Stool guaiac
- Colonoscopy or flex signoidoscopy considered (ordered by GI, hard to justify in primary care without abnormal labs)
When does IBS usually present and is it more common in men or women?
- Early adulthood (can present later)
- Women
3 ways to treat constipation dominant IBS?
- Fiber supplementation
- Osmotic laxative such as MOM or lactulose
- Avoid stimulant laxatives
3 ways to treat abd pain/bloating dominant IBS?
- Assess carefully for mechanical obstruction
- Antispasmodics administered before meals
- Refer for intractable pain or no improvement after 1 to 2 months of specific therapies
Increased bowel motility after eating results in _____ and urgency to defecate after eating.
Increased bowel motility after eating results in abd bloating and urgency to defecate after eating.
What 3 disorders are linked to IBS?
- Anxiety
- Depression
- Stress (exacerbates symptoms)
IBS is though to be a disorder of altered _____ and altered visceral sensation.
IBS is though to be a disorder of altered bowel motility and altered visceral sensation.
