Functional GI Disorders Flashcards
4 categories of functional GI disorders
functional dyspepsia
belching disorders
chronic nausea and vomiting disorders
rumination syndrome
what two syndromes come under functional dyspepsia
postprandial distress syndrome
epigastric pain syndrome
what is rumination syndrome
habit of regurgitating food which has already been digested
diagnostic criteria for functional dyspepsia
symptom onset more than 6 months ago
symptoms experienced for last 3 months
one or more of:
- bothersome postprandial fullness
- bothersome early satiety
- bothersome epigastric pain
- bothersome epigastric burning
and no evidence of structural disease that is likely to explain symptoms
structural disease must be ruled out with an endoscopy
what is post-prandial distress syndrome
type of functional dyspepsia
fullness and satiety but no pain
gastric dysmotility or abnormal accommodation
what is epigastric pain syndrome
type of functional dyspepsia
pain and burning due to visceral hypersensitivity
new onset of dyspepsia >55 is likely to be
oncogenic disease
epigastric pain syndrome is due to hypersensitivity which can be treated by
SSRIs
what nerve supplies parasympathetic to gut
vagus
what type of synapse is parasympathetic supply to gut
cholinergic
what type of synapse is sympathetic
adrenergic
diagnostic criteria for IBS
abdominal pain
and
2 of
- pain related to defaecation
- change in stool frequency
- change in stool form
symptoms over 6 months
weekly for last 3 months
feature of pathophysiology of IBS
visceral hypersensitivity
what are the 4 types of IBS
IBS-C (constipated)
IBS-M (mixed)
IBS-D (diarrhoea)
IBS-U (unclassified)
what bristol stool classification is IBS-C
1 and 2
what bristol stool classification is IBS-D
6 and 7
what bristol stool classification is IBS-M
1 and 6
what two symptoms cannot be attributed to IBS without further investigation and exclusion of more sinister causes
rectal bleeding
nocturnal diarrhoea
what does onset of IBS often follow
gastroenteritis
e.g. campylobacter infection
symptoms of IBS
bloating
abdo distension
post-prandial urgency
diarrhoea-constipation alternating
passing mucus
sensation of incomplete evacuation
what conditions are associated with IBS
migraine
dyspepsia
dyspareunia
bladder problems
fibromyalgia
chronic fatigue
red flags to suggest other diagnosis than IBS
weight loss
rectal bleeding
anaemia
thrombocytosis
persistent diarrhoea
new onset over 50
frequent nocturnal symptoms
FHx bowel cancer/IBD
what dietary changes help some with IBS
low FODMAP
lactose restriction
wheat/gluten restriction
what is medication based on for IBS
on predominant symptom
third treatment option other than drugs and diet
CBT
psychological therapies
hypotherapy
relaxation therapy
