GI diseases: IBS

Question 1

What is IBS?
What % of population is affected?
Who is most at risk?

Answer 1

IBS = long-term or recurrent disorder of gastrointestinal (GI) functioning.
- Usually involves large intestine and small intestine with disturbances of intestinal/bowel motor function and sensation

• 10-15% of population has IBS
• Affects people of all ages, most are under 50 and 2/3 is female

Question 2

IBS is also known as…. because…

Answer 2

-IBS = known as brain-gut disorder
Regulation of motor function and sensation also happens with the brain, which may also be impaired.

Question 3

What is the cause of IBS? What is not a cause, but can worsen symptoms?

Answer 3

 Exact cause unknown
 Symptoms may result from disturbance in the interaction of brain, nervous system and gut, which can cause changes in normal bowel movement and sensation
 Stress is not a cause, but can worsen symptoms

Question 4

What are symptoms of IBS?

Answer 4

• Abdominal pain + discomfort
• Altered bowel habit (chronic/recurrent diarrhoea, constipation or both)
• Pain relieved by defecation
• Associated with increase or decrease in bowel movement frequency
• Associated with bowel movements becoming harder or softer in consistency

Question 5

How is IBS diagnosed?

Answer 5

ROME 4 criteria (small list: questionnaire)

• Complaints more than three months
• Abdominal complaints with consistency + frequency of stools

–> Fulfil ROME criteria without red flags (blood in stool, high age..) = IBS

Question 6

How is IBS treated? Explain? Is this a cure?

Answer 6

Low FODMAP diet:
FODMAP = short-chain carbohydrates, which are problematic for IBS patients.
–>- Presence causes water to be dragged into small intestine. They travel to the large intestine, where bacteria use them for energy to survive, producing gasses, expanding the guts. Nerves send signals to brain: sensitive! Contributes to pain.

 Following the low FODMAP approach = no cure for IBS, but allows successful drug-free management of symptoms through diet in many patients.

Question 7

What are other treatment strategies for IBS?

Answer 7

• Use of a diary to help find factors that worsen or bring on symptoms
• Stress management, gut-directed hypnosis, biofeedback, relaxation, or pain management
  techniques
• The use of drug therapy
• The use of cognitive-behavioural therapy

Question 8

What are the main differences between IBD and IBS?

Answer 8

IBD = might also have blood in stools, fever, weight loss, ulcers
IBS = sensitive gut