IBS

Question 1

symptoms of IBS

Answer 1

• pain and disturbed defecation and/or symptoms of bloatedness and distention
• abdominal pain relieved with defecation or associated with a change in frequency or consistency of stool and or disturbed defecation (2 or more)
• altered frequency, stool form or stool passage
• passage of mucous
• exaggerated visceral pain receptors - lower tolerance for distention

Question 2

mechanism of IBS

Answer 2

• abnormal motility
• abnormal visceral perception
• psychological distress

Question 3

Manning criteria

Answer 3

• abdominal pain: with looser stools, more frequent BMs, eased after BMs
• abdominal distention
• mucous
• incomplete evacuation

Question 4

red flags that do not add up to IBS

Answer 4

• physical exam: abnormal exam, fever, positive occult stool
• historical: weight loss, onset in older patients, nocturnal wakening, family history of CA/IBD
• initial labs: decreased HgB, increased WBC, increased ESR, abnormal chemistry