Constipation and IBS Lecture Powerpoint Flashcards
Functional GI disorder
One of which there is no underlying cause, cannot find lab abnormalities or physical exam findings
Irritable Bowel Syndrome definition
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
Diagnostic criteria Rome IV for Irritable bowel syndrome
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
Irritable bowel syndrome prevalence
- most commonly diagnosed GI condition
- up to 50% of all GI referrals
- onset in late 20’s, rarely over 40
Irritable bowel syndrome signs and symptoms (4)
- abdominal pain usually lower quadrant, RELIEVED by defacation
- bloating/distention
- mucus in stools
- constipation or diarrhea
4 IBS subtypes
Predominant constipation (most common) Predominant diarrhea Mixed bowel habits Unclassified
Red flags that something is NOT simple as IBS (6)
- onset after age 50
- weight loss
- recent travel preceding
- blood in stool
- nocturnal pain
- unexplained vomiting
Possible etiologies of IBS (5)
- inflammation
- food sensitivity
- psychosocial dysfunction
- visceral hypersensitivity
- alterations to GI motility
Extraintestinal complaints and IBS
High incidence of other dysfunction occurring in the body co-occurring with IBS
Lab studies for IBS (3)
- fecal calprotectin or fecal lactoferrin
- stool for ova and parasites
- possible colonoscopy
IBS treatment options (3)
- reduce stress
- avoid triggers
- exercise
Low FODMAP diet
Diet used to help alleviate IBS symptoms by limiting diets in fermentable oligo/di/monosaccharides that can cause colon bloating and pain
IBS prognosis
-no progression to cancer or inflammatory disease, but should expect recurrences
Constipation is a ___ not a ___
symptom, disease
Constipation definition
Less than 3 stools per week, but more specifically any alteration in consistency, motility, or caliber in the process of rectal evacuation
Constipation Rome IV diagnostic criteria
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
3 types of chronic constipation
- Extracolonic (low fiber, inadequate water, anorexia, atonia, medication)
- mechanical (narrowing due to tumor, hemorrhoids, colitis, stricture)
- functional (slow transit or normal transit)
Perceived constipation
Occurs when an individual expects a daily bowel movement that results in overuse of laxitives, enemas, etc
Colonic disorders and the elderly
-no evidence that aging slows gut motility in active healthy individuals, often associated with lifestyle changes and systemic disorders and medications causing their constipation
Physiologic studies for constipation
Used by GI specialists when all alternatives have been considered to assess etiology of constipation inclduing anal manometry, balloon insertion, etc
First 2 choice medications to treat constipation
- fiber
- mirilax (polyethylene glycol)