GI Disorders - Irritable Bowel Syndrome (IBS)

Question 1

What is IBS?

Answer 1

IBS is a common motility and sensation disorder

Question 2

Characteristics of IBS (5)

Answer 2

• most common GI disorder
• range from mild to severe
• no clear explanation
• individual experience pain during peristalsis
• no abn structure or biochemistry

Question 3

Etiology (3)

Answer 3

• unclear
• proposed links to lactose, smoking, dairy, stress, and diet
• FODMAPS

Question 4

What are FODMAPS?

Answer 4

F = fermentable 
O = Oligosaccharides
D = Disaccharides
M = monosaccharides
And 
P = polyols
S = polyols --> Sugar and ALcohols

Question 5

What are two factors that aggravate symptoms?

Answer 5

• stress and smoking

Question 6

Patho of IBS

Answer 6

alternative regulation of GI motor and sensory functions

Question 7

Two theories of IBS (patho):

Answer 7

1. polyols and fermentables CHO processed by gut flora

2. serotonin signalling defect

Question 8

In IBS, GI system cannot process ____ and ____. What happens?

Answer 8

Sugar and fermentable CHO. Gas gets trapped in GI tract and produces discomfort and contributes to pain.

Question 9

What is serotonin? Where is it secreted? By what cells?

Answer 9

Serotonin is a neurotransmitter secreted by enterochromaffin cells in the gut mucosa of the intestines.

Question 10

Primary and secondary site of synthesis of serotonin:

Answer 10

1. gut mucosa

2. nervous system

Question 11

What are the function of serotonin in GIT? (4)

Answer 11

1. sensation -pain
2. motility
3. secretion - acid, enzymes, and mucous
4. perfusion

Question 12

How does serotonin contribute to IBS symptoms?

Answer 12

Serotonin molecular signalling defect causes:

• xs mucous secretion in the gut (mucoid stool)
• decrease perfusion in bowel = decrease function
• sensation of pain during peristalsis

Question 13

Manifestations of IBS (5)

Answer 13

• varied on severity
• dyspepsia
• flatulence
• mucoid stool
• diarrhea and constipation

Question 14

What is dyspepsia?

Answer 14

discomfort or pain felt in upper abdomen after eating and drinking

Question 15

Malabsorption?

Answer 15

disorder that occurs when nutrients in diet aren’t absorbed properly eg. CHO, fat, and proteins

Question 16

Diagnosis is done by ____ of ____ ____

Answer 16

exclusion of organic disease

Question 17

Diagnosis of IBS: Labs (3)

Answer 17

• CBC
• Serology - antibody test
• Examine stool parasites - to exclude parasitic infection

Question 18

Diagnosis of IBS: Scopes

Answer 18

Gastroscopy = inserted to upper GIT thru mouth to beginning of duodenum

Colonoscopy = inserted into GIT by rectum to the duodenum

Biopsy sample can be obtained during the procedures

to visualize polyps or ulcers

Question 19

If all tests are negative, IBS can be diagnosed thru ____

Answer 19

presentation - looking at the manifestations

Question 20

Treatment of IBS

Answer 20

• avoid offending food
• decrease stress
• drugs prn (antibiotics, antispasmodics, and antidiarrheals)

Question 21

How does antispasmodics help?

Answer 21

Help relieve contractions of the gut to alleviate symptoms caused by peristalsis

Question 22

How can antidiarrheals help?

Answer 22

alternate bowel patterns

Question 23

Antibiotics? Why used with caution?

Answer 23

To control the overgrowth of bacteria.

Normal flora can be wiped out and pathogenic flora can be established in the gut

Antibiotic resistance can develop.