Gastrointestinal Tract-IBS Flashcards
What triggers IBS?
Stress, anxiety, alcohol, fatty food, spicy food etc.
Groups IBS most common in?
20-30 years of age and women
Non-drug treatment of IBS?
-Increase physical activity
-Have regular meals without long gaps
-Increase fluid intake to up to 8 cups/day
-Reduce fresh fruit consumption to max 3 portions/day
-If diarrhoea present; avoid sorbitol sweeteners
-Review fibre intake- increase soluble fibre intake with isphagula husk, sterculia and from foods such as oats.
-Reduce insoluble fibre e.g. bran and resistant starch.
-Reduce caffeine, alcohol and fizzy drinks.
Drug treatment of IBS?
Antispasmodics/antimuscarinics e.g. hyoscine, mebeverine and peppermint oil for GI cramps.
Laxatives for constipation-avoid Lactulose causes bloating.
Constipation>1 year + not responded to laxatives–> Linaclotide (reduce bloating, gas and constipation for moderate-severe IBS C)
Diarrhoea: Loperamide
Bloating: Peppermint Oil
Cognitive therapy with CBT if no relief of symptoms >12m
Antidepressants e.g. TCA (amitryptilline) and SSRIs (fluoxetine) (unlicensed) if not responding to laxatives, antispasmodics or loperamide). 1st line TCA, if not responded try SSRIs
Loperamide licensing?
> 12 years for acute diarrhoea: Two capsules immediately and then one capsule after each bout of diarrhoea or vomiting max 6 capsules per day (12 mg)
For diarrhoea associated with IBS: >18
Buscopan IBS licensing?
> 12 years after confirmed diagnosis. 1 tablet tds, maximum 2 tablets qds.
Normal buscopan licensing?
> 6.
Summary for coeliac disease?
Caused by gluten that results in the release of antibodies damaging the small intestine.
Complications surrounding include malabsorption resulting in vit D and Calcium deficiency hence, 2ndary osteoporosis, Iron and Folate deficiency leading to iron def anaemia and folate deficiency anaemia.
Treatment is GF diet, antispasmodics.
Summary of Diverticulosis
Age and low fibre diet result in stools not passing properly leading to damaged large intestines and pouches called Diverticula. Diverticulosis is asymptomatic and treatment is increase in fibre intake and potentially fibre based laxatives such as isphagula husk and sterculia.
Summary of Diverticular Disease
Diverticular disease involves diverticula with symptoms of abdominal pain, diarrhoea and rectal bleeding. Treatment is increase in fibres and paracetamol (AVOID NSAIDs can cause perforated diverticula)
Summary of diverticulitis
Diverticula resulting in infection and inflammation, severe abdominal pain and persistent diarrhoea and constipation.
Complications involve fistula, perforation, obstruction and abscess.
Treatment is increase in fibre, paracetamol for pain, Antibiotics for infection and Surgery.
