GI Guidelines

Question 1

What are the typical IBS symptoms?

Answer 1

**vary in severity & stool consistency
- abdo pain
- bloating
- flatulence
- early satiety
- discomfort
- Changes in bowel routine
- Changes in stool consistency

Question 2

How do we classify IBS? Describe the stool types that correspond to each type of IBS based on the Bristol stool chart

Answer 2

IBS-constipation (IBS-C) is predominantly type 1 and 2
 IBS-diarrhea (IBS-D) is predominantly type 6 and 7
 IBS-mixed (IBS-M) is a high predominance of both constipation and diarrhea
 IBS-unclassified (IBS-U) is the infrequent appearance of either constipation or diarrhea

Question 3

Describe the general approaches to IBS management

Answer 3

As there is no known cure for IBS, treatment focuses on reducing symptoms through
- lifestyle management
- relaxation therapies and stress reduction
- dietary adjustments
- medication management

Question 4

Name triggers for IBS symptoms

Answer 4

Fat
Alcohol
Caffeine
Poorly absorbed carbohydrates (sugar alcohols, lactose, wheat, fructose)
Psychological stress

Question 5

What kind of diet should people with IBS follow according to the Alberta Health Services guidelines?

Answer 5

• “healthy diet” following Canada’s food guide
• consume more fibre
• antioxidant and inflammatory rich foods
• limited processed & friend foods & those high in saturated fats
• eat small meals and snacks throughout the day

(also low FODMAP & elimination possibly)

Question 6

What kind of fibre is recommended for IBS? Name sources of fibre that may be helpful and which may trigger IBS symptoms

Answer 6

Soluble fibre = good for IBS
- oats, barley, psyllium, pectin, flaxseed

Insoluble fibre = bad for IBS (can trigger symptoms)
- wheat bran, cellulose, raw veggies and fruit

Question 7

T/F management of anxiety/depression via CBT and other therapies/relaxation/hypnotherapy can be beneficial for IBS

Answer 7

True :)

Question 8

T/F Exercise is often a trigger for IBS so only low intensity exercise should be performed

Answer 8

False - physical activity is beneficial for all patients with IBS (20-30mins most days of the week)

Question 9

T/F Patients with IBS should expect to follow a FODMAP diet for their lifetime

Answer 9

False - this is a TEMPORARY DIET!

 Elimination trials of a single nutrient/food (e.g. lactose, gluten) or multiple nutrients/foods (e.g. LowFODMAP Diet) are short term and may be required in some patients with suspected food intolerances.
The low-FODMAP diet trial may improve gastrointestinal symptoms, abdominal pain, and distension.
The RD can support patients compliance with the complex dietary restrictions outlined in the lowFODMAP diet as well as ensure they are consuming adequate nutrients.

Question 10

When are medications used for IBS?

Answer 10

For patients who don’t adequately respond to diet and lifestyle adjustments

Question 11

Before an IBS diagnosis, clients should be screened for what?

Answer 11

Celiac disease & red flag features (which includes full medical hx and physical exam)

Question 12

What are the 5 red flags of GI that need to be ruled out before a diagnosis of IBS?

Answer 12

1) Bleeding/anemia
2) Weight loss
3) Nocturnal or progressive symptoms
4) Onset after age of 50
5) Family hx of IBD, colorectal CA or celiac disease