GI Disorders - Irritable Bowel Syndrome (IBS) Flashcards
What is IBS?
IBS is a common motility and sensation disorder
Characteristics of IBS (5)
- most common GI disorder
- range from mild to severe
- no clear explanation
- individual experience pain during peristalsis
- no abn structure or biochemistry
Etiology (3)
- unclear
- proposed links to lactose, smoking, dairy, stress, and diet
- FODMAPS
What are FODMAPS?
F = fermentable O = Oligosaccharides D = Disaccharides M = monosaccharides And P = polyols S = polyols --> Sugar and ALcohols
What are two factors that aggravate symptoms?
- stress and smoking
Patho of IBS
alternative regulation of GI motor and sensory functions
Two theories of IBS (patho):
- polyols and fermentables CHO processed by gut flora
2. serotonin signalling defect
In IBS, GI system cannot process ____ and ____. What happens?
Sugar and fermentable CHO. Gas gets trapped in GI tract and produces discomfort and contributes to pain.
What is serotonin? Where is it secreted? By what cells?
Serotonin is a neurotransmitter secreted by enterochromaffin cells in the gut mucosa of the intestines.
Primary and secondary site of synthesis of serotonin:
- gut mucosa
2. nervous system
What are the function of serotonin in GIT? (4)
- sensation -pain
- motility
- secretion - acid, enzymes, and mucous
- perfusion
How does serotonin contribute to IBS symptoms?
Serotonin molecular signalling defect causes:
- xs mucous secretion in the gut (mucoid stool)
- decrease perfusion in bowel = decrease function
- sensation of pain during peristalsis
Manifestations of IBS (5)
- varied on severity
- dyspepsia
- flatulence
- mucoid stool
- diarrhea and constipation
What is dyspepsia?
discomfort or pain felt in upper abdomen after eating and drinking
Malabsorption?
disorder that occurs when nutrients in diet aren’t absorbed properly eg. CHO, fat, and proteins
Diagnosis is done by ____ of ____ ____
exclusion of organic disease
Diagnosis of IBS: Labs (3)
- CBC
- Serology - antibody test
- Examine stool parasites - to exclude parasitic infection
Diagnosis of IBS: Scopes
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
If all tests are negative, IBS can be diagnosed thru ____
presentation - looking at the manifestations
Treatment of IBS
- avoid offending food
- decrease stress
- drugs prn (antibiotics, antispasmodics, and antidiarrheals)
How does antispasmodics help?
Help relieve contractions of the gut to alleviate symptoms caused by peristalsis
How can antidiarrheals help?
alternate bowel patterns
Antibiotics? Why used with caution?
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.
