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Clinical health midterm2 > Gastrointestinal disorders: IBS & other disorders > Flashcards

Gastrointestinal disorders: IBS & other disorders Flashcards

1
Q

Irritable Bowel Syndrome

A

Chronic functional gastrointestinal disorder

  • hypervigiliance to gastrointestinal sensation + abdominal pain
  • IBS is characterized more by symptoms, suffering and disability than by demonstrable organic abnormality
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2
Q

Prevalence of IBS

A

7-12%

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3
Q

Gender differences in IBS

A

Symptoms are stronger in woman than in men

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4
Q

CBT & IBS

A

Particlulary effective in improving IBS related outcomes. How it is effective is unclear.

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5
Q

IBS people receiving CBT

A

Reported less fear avoidance, catastrophizing and damaging belief compared to treatment as usual (TAU) group.

CBT patient, but not TAU, has more positive illness perception and shifted from attributing symptoms predominantly to physical cause to viewing symptoms are related to both physical and psychological causes.

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6
Q

IBS is often linked to…

A

stress, anxiety, catastrophic thinking, and negative affect

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7
Q

Mindfullness training promotes…?

A

nonreactive awareness of emotional and sensory experience, and may target underlying mechanisms of IBS, including affective pain processing and catastrophic appraisal of gastrointestinal sensations.

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8
Q

Most common psychological therapy for IBS

A

CBT and clinical hypnosis

Hypnosis: a significant reduction in maladaptive IBS-related cognitions, affective symptoms, and somatization are frequently reported along with improvement in gastrointestinal symptoms.

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9
Q

readings (garland, gaylord etc.) - result about Mindfulness Training and IBS

A

their research suggest that MT substantially reduce IBS symptoms and relieve the often severe impairments in quality of life that characterize the disorder.

MT lead to increased non-reactivity to cognition, emotional, and physiological sensations.

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10
Q

Brain region involved in pain relieve after cognitive interventions

A

Anterior cingulate cortex and lateral prefrontal cortex

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11
Q

Symptoms of IBS

A

Abdominal pain, discomfort, bloating, altered bowel habits

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12
Q

Four subtypes of IBS

A
  • IBS-D: diarrhea predominant
  • IBS-C: constipation predominant
  • Mixed IBS
  • Unsybtyped IBS
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13
Q

Rome criteria for diagnosis of IBS

A
  • Abdominal pain/discomfort at least 3 days - months in the last 3 months
  • 2 or more of the following: improvement with defecation, onset association with change in frequency of stool, onset associated with change in form of stool
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14
Q

IBS + from doctor perspective

A

There is some diagnosis that can be mixed with IBS, and every other diagnosis has to be eliminated before given the IBS diagnosis like celiac disease, chronic disease, colorectal cancer

red flags:

  • symptom after 50 y
  • severe worsening symptoms
  • unexplained weight loss
  • family history of organic gastroenterological diseases
  • Rectal bleeding
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15
Q

The pathogenesis/development of IBS

A 
Dysregulation of gut-brain homeostasis
Altered gut motility and gut permeability
Visceral hypersensitivity
Characteristic of stress response
Biopsychosocial approach
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16
Q

The relationship between stress and gastrointestinal disease

A

stress is an acute threat to the homeostasis of the person. HPA axis, cortisol release, right and flight response

17
Q

Allostasis

A

Maintaining stability through physiological or behavioral change

18
Q

Allostatic load

A

The cost of chronic exposure to elevated endocrine or neural responses resulting from chronic or repeated stress.

19
Q

Possible role of allostasis in chronic gastrointestinal disorders

A

the blunting of HPA axis may precede the onset of Its symptoms due to stress. in IBS, persistent alteration of autonomic responsiveness is likely to play a role in alteret gastric emptying and bowel habits.

20
Q

Psychiatric comorbidity psychiatric disorders

A

60 % of IBS also have psych. condition, and most common is; depression, GAD, insomnia, panic disorder. the risk is highest within the first year of IBS diagnosis.

comorbid psychiatric disorders are associated with;

  • increased psychological stress
  • reduced physical and mental functioning
  • more severe IBS symptoms
  • Impairment in daily functioning
  • Diagnositc delay
21
Q

IBS and panic disorders

A

the hypersensitivity and hyperviilance to gut sensation observed in IVs is analogous to the sensitivity to bodily sensations observed in panic disorders

22
Q

Treatment for mild IBS

A

education, lifestyle, intervention, food intolerance testing

23
Q

Treatment for moderate IBS

A

Gut medication, mental health professions

24
Q

Treatment for severe IBS

A

amultidiciplanry approach, medical treatment, psychological interventions

25
Q

CBT + IBS

A
  • improved symptom severity
  • Pos. mental health outcome
  • changes in maladaptive illness-related beliefs
  • more positive illness perception
  • More coherent understanding of the illness
  • Reduction in maladaptive coping strategies
26
Q

Mindfulness + IBS

A

promotes non reactivity to gut-focused anxiety and catastrophic appraisal of abdominal sensations coupled with a refocusing of attention with less emotional interference.

improved symptom severity and QoL.

27
Q

Hypnotherapy + IBS

A

Gut-focused hypnotherapy: decrease hypervigiliance, depression and anxiety.

28
Q

Functional esophageal disorders

A
  • Functional heartburn
  • Functional chest pain
  • Functional dysphagia
29
Q

Functional heart burn

A

Persistent heartburn symptom with normal findings on endoscopy

30
Q

Functional chest pain

A

angina-like chest pain with normal coronary anatomy and no detectable gastroenterological or respiratory cause
Hyperalgeisa?

Treatment with antidepressant has been proven effective randomized clinical trials

31
Q

Hyperalgesia

A

Increased sensitivity to pain

32
Q

Functional dysphagia

A

dysphagia (takes more time to swallow)

33
Q

Functional dyspesia

A

Pain and discomfort in the upper abdomen that is not associated with structural defects such as gastro-esophageal reflux and is not due to metabolic conditions .

34
Q

Functional diarrhea vs IBS

A

Loose or watery stools without pain occurring in at least 75%.

The clinical characteristics and demographics of functional diarrhea and IBS-D patients are very similar, but the diarrhea symptoms in IBS-D are substantially more severe.

Clinical health midterm2 (8 decks)

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