functional bowel disease Flashcards
criteria for IBS name
rome III
what is the ROME III say
- 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
types of functional bowel disease
- mucous colitis
- neurogenic mucous colitis
- colonic spasm
- irritable colon
- irritable colon syndrome
- irritable bowel syndrome
IBS cause
- 5Ht mediated visceral hypersensitivity and gut motility
- abnormal motor function
bad prognosis factors for IBS
- if bowel don’t move regularly
- faeces are retained and constipation occurs with tympanites
- stool is small and hard
causes of IBS
- stress
- depression
- hormone change
- food
- infection
- chemical
- trauma
- anxiety
what does scybala mean
hardened lumps of faeces
how does post-infection cause IBS
bacterial infection acute gastroenteritis-> gut dysfunction genetic susceptibility +behavioural factors and stress-> post-infective IBS
what releases serotonin
enterochromaffin cells when change in chemical environment
what does serotonin do
initiate peristalsis
what are the serotonin receptors in the colon and function
5HT-4 trigger peristaltic reflex
what is an agonist of 5HT4
prucalopride
subtypes of IBS
IBS-c constipation
IBS-D diarrhoea
IBS-m mixed
IBS-u unsubtyped
other symptoms of IBS
tiredness backache bloating dyspepsia urinary requency nocturia sleep disorder fibromyalgia psychological
ibs alarm symptoms
-rectal bleeding weight loss persistnet anaemia new onset >50 fhx bowel cancer absence of psychological distress
diff dx of ibs
infection ibd bacterial overgrowth diverticular disease colon cancer hormonal
ibs investigation
- uss
- ct
- colonoscopy
- stools culture
treatment for ibs
diarrhoea -bulk form=fybogel -loperamide,codeine constipation -fibre -osmotic laxatives -antidepressants eg amitriptyline TCA -antispasmodics eg mebverine/hyoscine -serotenic 5ht3/4
what does metoclopramide work at
5th4 agonist
5ht3 antagonist
cisapride work at
5ht2/3 antagonist and 5ht4 agonist
tegaserod work at
5ht4/1 agonist
5ht2 antagonist
which drug is a selective agonist of 5ht4
prucalopride
what does prucalopride do
stimulate motility
causes release of ach
for constipation
prucalopride vs laxatives in where they work and quick
laxatives act in gut lumen
prucalopride acts on gut wall so more rapid
other treatments for ibs
-cbt
-meditation
biofeedback
how does biofeedback work
self-regulatory treatment
emg or manometry to record what sets off or causes inappropriate response
