functional bowel disease Flashcards

1
Q

criteria for IBS name

A

rome III

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2
Q

what is the ROME III say

A
  • recurrent abdominal pain, bloating or change in bowel habit for at least 3days/month for 6 months
  • improves with defecation
  • onset assoc. to change in stool frequency or formation
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3
Q

types of functional bowel disease

A
  • mucous colitis
  • neurogenic mucous colitis
  • colonic spasm
  • irritable colon
  • irritable colon syndrome
  • irritable bowel syndrome
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4
Q

IBS cause

A
  • 5Ht mediated visceral hypersensitivity and gut motility

- abnormal motor function

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5
Q

bad prognosis factors for IBS

A
  • if bowel don’t move regularly
  • faeces are retained and constipation occurs with tympanites
  • stool is small and hard
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6
Q

causes of IBS

A
  • stress
  • depression
  • hormone change
  • food
  • infection
  • chemical
  • trauma
  • anxiety
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7
Q

what does scybala mean

A

hardened lumps of faeces

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8
Q

how does post-infection cause IBS

A
bacterial infection
acute gastroenteritis->
gut dysfunction
genetic susceptibility +behavioural factors and stress->
post-infective IBS
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9
Q

what releases serotonin

A

enterochromaffin cells when change in chemical environment

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10
Q

what does serotonin do

A

initiate peristalsis

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11
Q

what are the serotonin receptors in the colon and function

A

5HT-4 trigger peristaltic reflex

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12
Q

what is an agonist of 5HT4

A

prucalopride

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13
Q

subtypes of IBS

A

IBS-c constipation
IBS-D diarrhoea
IBS-m mixed
IBS-u unsubtyped

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14
Q

other symptoms of IBS

A
tiredness
backache
bloating
dyspepsia
urinary requency
nocturia
sleep disorder
fibromyalgia 
psychological
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15
Q

ibs alarm symptoms

A
-rectal bleeding
weight loss
persistnet
anaemia
new onset >50
fhx bowel cancer
absence of psychological distress
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16
Q

diff dx of ibs

A
infection
ibd
bacterial overgrowth
diverticular disease
colon cancer 
hormonal
17
Q

ibs investigation

A
  • uss
  • ct
  • colonoscopy
  • stools culture
18
Q

treatment for ibs

A
diarrhoea
-bulk form=fybogel
-loperamide,codeine
constipation
-fibre
-osmotic laxatives
-antidepressants eg amitriptyline TCA
-antispasmodics eg mebverine/hyoscine
-serotenic 5ht3/4
19
Q

what does metoclopramide work at

A

5th4 agonist

5ht3 antagonist

20
Q

cisapride work at

A

5ht2/3 antagonist and 5ht4 agonist

21
Q

tegaserod work at

A

5ht4/1 agonist

5ht2 antagonist

22
Q

which drug is a selective agonist of 5ht4

A

prucalopride

23
Q

what does prucalopride do

A

stimulate motility
causes release of ach
for constipation

24
Q

prucalopride vs laxatives in where they work and quick

A

laxatives act in gut lumen

prucalopride acts on gut wall so more rapid

25
Q

other treatments for ibs

A

-cbt
-meditation
biofeedback

26
Q

how does biofeedback work

A

self-regulatory treatment

emg or manometry to record what sets off or causes inappropriate response