functional GI disorders Flashcards
what are functional GI disorders ?
a disorder compromising symptoms arising in the mid or lower GIT that are not associated with anatomic or biochemical defects
what are the 3 most common functional GI disorders ?
IBS
functional dyspepsia
constipation
what is irritable bowel syndrome?
is a GIT syndrome characterized by chronic abdominal pain and altered bowel habits in the absence of any organic cause
what are the subtype of IBS?
IBS with constipation
IBS with diarrhea
Mixed IBS
Unsubtyped IBS
what criteria is used for IBS?
Rome IV criteria
what is the time period required to fulfil the criteria of IBS?
for the past 3 months with symptom onset at least 6 months prior to diagnosis
what are the criteria to diagnose IBS by the Rome IV criteria ?
- abdominal pain at least once a week in the last 3 months which is associated with at least 2 of:
- pain related to defecation
- associated with a change in stool frequency
- associated with a change in form of stool
what is the cause of the diarrhea if the diarrhea wakes the patient up?
organic and not functional
what are some alarming or atypical symptoms that are not compatible with IBS ?
rectal bleeding
nocturnal or progressive abdominal pain
weight loss
anemia, elevated inflammatory markers or electrolyte disturbances
what does the diagnostic evaluation mainly depend on ?
whether the predominant symptom is diarrhea or constipation
if the predominant symptom is diarrhea what are the diagnostic approaches ?
stool cultures
celiac disease screening
24 hour stool collection if malabsorption is suspected
colonscopy or flexible sigmoidoscopy
if the predominant symptom is constipation what are the diagnostic approaches ?
colonoscopy or flexible sigmoidoscopy
what is the treatment approach to IBS ?
patient education dietary modification n diarrhea management constipation management pain management
what are some of the dietary modifications required ?
FODMAPs restriction gluten avoidance lactose avoidance food allergies testing dietary fibre and physical activity should be encouraged
in patients who have IBS-C and failed a trial of soluble fibre what is the next best step ion management ?
osmotic laxatives
chloride channel activators lubiprostone
5HT4 R