IBS

Question 1

What is IBS?

Answer 1

a functional bowel disorder - you get GI symptoms as a result of abnormal functioning of the gut when its an otherwise normal bowel

Question 2

How many people have IBS?

Answer 2

20% of the population

Question 3

What are risk factors for IBS?

Answer 3

stress
acute episode of gastroenteritis
female
young adult

Question 4

What are the symptoms of IBS?

Answer 4

Fluctuating diarrhoea with constipation
Abdominal bloating
abdominal pain

*symptoms worse after eating and relieved after going to the toilet

Question 5

What investigations are done?

Answer 5

Faecal calprotectin
FBC
CRP
ESR
^ (raised in IBD)
Anti TTG antibodies - to exclude coeliac 
Colonoscopy - if it might be cancer

Question 6

What is the NICE diagnosis for IBS?

Answer 6

Abdominal pain or discomfort that’s relieved with opening the bowels or a change in bowel habit

2 of the following:
abnormal stool passage
bloating
symptoms worse after eating
mucous associated with bowel movements

Question 7

What is the management of IBS?

Answer 7

Low LODMAP diet
Probiotic supplements
Lapropimide (for diarrhoea)
Laxatives - not lactulose to avoid bloating (for constipation)
Linactelide - specialist laxative when not responding to first line
hyacine butyl bromide or buscapan - anti spasmodics

Question 8

what are 2nd Line medications?

Answer 8

TCA - amitriptyline

Question 9

What are 3rd line medications?

Answer 9

SSRI

CBT

Question 10

What odes IBD include that IBS doesn’t?

Answer 10

inflammation, ulcers and other damage to the bowel