Constipation and IBS Lecture Powerpoint

Question 1

Functional GI disorder

Answer 1

One of which there is no underlying cause, cannot find lab abnormalities or physical exam findings

Question 2

Irritable Bowel Syndrome definition

Answer 2

Chronic condition of the digestive system with abdominal pain and changes in bowel habits (constipation/diarrhea), sees functional disturbance in intestinal motility and visceral perception strongly influenced by emotional factors either 1 of 4 subtypes

Question 3

Diagnostic criteria Rome IV for Irritable bowel syndrome

Answer 3

Recurrent abdominal pain occurring at elast 1 day a week for 3 months associated with relatioship to defacation, change in stool frequency, and associated change in stool form/appearance

Question 4

Irritable bowel syndrome prevalence

Answer 4

• most commonly diagnosed GI condition
• up to 50% of all GI referrals
• onset in late 20’s, rarely over 40

Question 5

Irritable bowel syndrome signs and symptoms (4)

Answer 5

• abdominal pain usually lower quadrant, RELIEVED by defacation
• bloating/distention
• mucus in stools
• constipation or diarrhea

Question 6

4 IBS subtypes

Answer 6

Predominant constipation (most common)
Predominant diarrhea
Mixed bowel habits
Unclassified

Question 7

Red flags that something is NOT simple as IBS (6)

Answer 7

• onset after age 50
• weight loss
• recent travel preceding
• blood in stool
• nocturnal pain
• unexplained vomiting

Question 8

Possible etiologies of IBS (5)

Answer 8

• inflammation
• food sensitivity
• psychosocial dysfunction
• visceral hypersensitivity
• alterations to GI motility

Question 9

Extraintestinal complaints and IBS

Answer 9

High incidence of other dysfunction occurring in the body co-occurring with IBS

Question 10

Lab studies for IBS (3)

Answer 10

• fecal calprotectin or fecal lactoferrin
• stool for ova and parasites
• possible colonoscopy

Question 11

IBS treatment options (3)

Answer 11

• reduce stress
• avoid triggers
• exercise

Question 12

Low FODMAP diet

Answer 12

Diet used to help alleviate IBS symptoms by limiting diets in fermentable oligo/di/monosaccharides that can cause colon bloating and pain

Question 13

IBS prognosis

Answer 13

-no progression to cancer or inflammatory disease, but should expect recurrences

Question 14

Constipation is a ___ not a ___

Answer 14

symptom, disease

Question 15

Constipation definition

Answer 15

Less than 3 stools per week, but more specifically any alteration in consistency, motility, or caliber in the process of rectal evacuation

Question 16

Constipation Rome IV diagnostic criteria

Answer 16

2 or more for the past 3 months with symptoms at least 6 months

• lumpy hard stools >25% of time
• straining
• sensation of incomplete evacuation
• Insufficient criteria for IBS

Question 17

3 types of chronic constipation

Answer 17

• Extracolonic (low fiber, inadequate water, anorexia, atonia, medication)
• mechanical (narrowing due to tumor, hemorrhoids, colitis, stricture)
• functional (slow transit or normal transit)

Question 18

Perceived constipation

Answer 18

Occurs when an individual expects a daily bowel movement that results in overuse of laxitives, enemas, etc

Question 19

Colonic disorders and the elderly

Answer 19

-no evidence that aging slows gut motility in active healthy individuals, often associated with lifestyle changes and systemic disorders and medications causing their constipation

Question 20

Physiologic studies for constipation

Answer 20

Used by GI specialists when all alternatives have been considered to assess etiology of constipation inclduing anal manometry, balloon insertion, etc

Question 21

First 2 choice medications to treat constipation

Answer 21

• fiber

- mirilax (polyethylene glycol)