Galligan IBS lecture (same from psych)

Question 1

What are the Rome III criteria for Irritable Bowel Syndrome?

Answer 1

at least 12 weeks (need not be consecutive) in past 12 months w/ abdominal discomfort or pain that has 2 of 3 features:

1) relieved w/ shitting and/or
2) onset associated w/ change in frequency of shitting and/or
3) onset associated w/ change in form of shit (aka butt pee vs solid)

Question 2

How is IBS different from IBD?

Answer 2

IBS is mostly a diagnosis of exclusion… IBD includes things like Crohns and ulcerative colitis… but IBS is whats left after cancer, IBD, food allergy, infection, drug side-effects are ruled out…

Question 3

What is the pathophys of IBS?

Answer 3

changes in 5-HT signaling in gut are the only thing known to contribute right meow… (note patients can have putt pee or constipation or both w/ IBS)

Question 4

What is alosetron? and who/what does it treat?

Answer 4

antagonist specific for 5-HT3 receptors that are found on neurons that control GI motility… and it reduces ONLY diarrheal form of IBS in females ONLY

Question 5

What are the 3 overlapping components of IBS?

Answer 5

1) motility disturbances
2) visceral hypersensitivity
3) cognitive/psychological factors

Question 6

Which one of the 3 components of IBS does alosetron help with?

Answer 6

ALL 3!

Question 7

How does genetics play into IBS?

Answer 7

SERT transporter polymorphisms… the Serotonin transporter (SERT) clears 5-HT from synapse… people with a homozygous “SS” aka low SERT expression are linked to people with IBS

Question 8

What is psychologically different about IBS patients?

Answer 8

IBS subjects are more sensitive to stress than healthy control subjects and psychological stress is positively correlated with symptom onset and severity.. psychological disturbances are present in up to 90% of IBS subjects..