IBS

Question 1

symptoms of IBS?

Answer 1

● Alternating constipation and diarrhoea
● Abdominal discomfort
● Passage of mucus
● Faecal urgency

Question 2

red flags for IBS?

Answer 2

● Children
● Adult over the age of 45 years with symptoms for the first time
● Rectal bleeding associated with a change in bowel habit
○ To exclude gastric carcinoma, gastric ulcer and inflammatory bowel diseases that present with this symptom
● Undiagnosed IBS
○ Needs to be referred to doctor for formal diagnosis and investigation
● Loss of appetite
● Fever
● Nausea and Vomiting
● Weight loss

Question 3

what is the lifestyle advise for IBS?

Answer 3

● Exercise has been shown to improve symptoms and should be recommended to patients
● Maintenance of adequate fluid intake (~2 Litres a day)
● Patients should be reassured that this condition, whilst chronic, is treatable and that certain “triggers” that lead to symptoms can be avoided.
● fatty food food and caffeine drink that may act as triggers includ

Question 4

treatment options for IBS?

Answer 4

IBS is a chronic condition and it should be explained to patients that they will be susceptible to exacerbations of symptoms. Treatment should be based on the symptoms currently being experienced by the patient.

• if constipation then go for bulk forming laxatives
• if diarrhoea then go for loperamide

Question 5

what are antispasmodic drugs?

Answer 5

Mebeverine (Colofac®), Alverine citrate (Spasmonal®), Peppermint oil (Colpermin®)

Question 6

when are antispasmodics used?

Answer 6

● Are used for symptoms of abdominal pain and cramps

● Act by relaxing the smooth muscle in the gut wall

Question 7

what are examples of antimuscarinic drugs?

Answer 7

Hyoscine Butylbromide (Buscopan®)

Question 8

how do antimuscarinic work?

Answer 8

Also relax smooth muscle and are thought to relieve abdominal pain and cramps