functional GI disorders Flashcards
functional GI disorder ?
GI disorder that are not associated with anatomical or biochemical effects
3 most common functional GI disorders ?
IBS, constipation and functional dyspepsia
what are the subtypes of IBS ?
IBS with constipation
IBS with diarrhea
Mixed IBS
Unsubtyped IBS
what is the Rome IV criteria for the diagnosis of IBS ?
abdominal pain criteria must be fulfilled for the past 3 months with the onset of symptoms from the past 6 months , with 2 or more off the following criteria :
related to defecation
associated with a change in frequency
associated with a change of form off the stool
what are the alarming symptoms that are not associated with IBS ?
rectal bleeding
progressive abdominal pain
weight loss
lab abnormalities
what is the diagnostic approach for patients suspected to have IBS
if diarrhea - stool culture, celiac screening
if constipation - colonoscopy or flexible sigmoidoscopy
what is the management in patients with IBS-C who failed soluble fibre ?
osmotic laxatives
locally acting chloride chanel activator
linaclotide
what is the management for patients with IBS-D ?
anti-diarrheal agents : loperamide
bile acid sequestrants : cholestyramine
5HT3 R antagonist
what is the side eeffect of 5HT3R antagonist ?
ischemic colitis
what is the definition of functional dyspepsia ?
predominant epigastric pain for at least 1 month ( the patient’s primary concern )
what is the first step in management in a patient with suspected functional dyspepsia ?
if above 60 years of age - perform endoscopy
if below 60 years of age - h.pylori test and treat if positive
if no response try PPI
if no response try TCA or prokinetic
if no response consider psychotherapy
