IBS Flashcards

1
Q

What is IBS?

A

A function bowel disorder - no identifiable organic disease underlying symptoms. Symptoms are a result of abnormal functioning of a otherwise normal bowel.

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2
Q

How do you diagnose?

A

Diagnosis of exclusion

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3
Q

% population affected?

A

10-20%

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4
Q

Symptoms suggesting IBS (NICE guidelines)?

A
  • Abdo discomfort/pain relieved on defecation OR assoc. with change in bowel habits (form, frequency)
  • AND 2 of:
  • -> altered passage (straining vs. urgency)
  • -> Bloating
  • -> Worse eating
  • -> passage of mucus
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5
Q

Pathology to exclude (NICE guidelines)?

A

1) Normal FBC, ESR + CRP
2) Negative faecal calprotectin - excludes IBD
3) Negative coeliac screen (anti-TTG)
4) cancer not suspected OR excluded if suspected

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6
Q

General management?

A

Advise there is no serious pathology:

  • adequate fluids
  • regular, small meals
  • avoid processed food
  • avoid caffeine + alcohol
  • low FODMAP
  • trial of probiotic supplements for 4 wks
  • CBT
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7
Q

1st line medication for:

a) diarrhoea
b) constipation
c) cramps

A

a) loperamide
b) laxatives - AVOID lactulose
c) hyoscine butylbromide (Buscopan)

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8
Q

Medication if first line laxatives dont help constipation?

A

Linaclotide

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9
Q

Second line medication?

A

Tricyclic antidepressant –> Amitriptyline 5-10mg at night

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10
Q

3rd line medication?

A

SSRIs

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11
Q

Symptoms that may indicate organic disease?

A

1) pain disturbs sleep
2) diarrhoea disturbs sleep
3) fever
4) PR bleed
5) weight loss

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