IBS Flashcards
1
Q
IBS
A
-chronic abd pain with altered bowel habits
2
Q
Rome IV criteria
A
-chronic abd pain at least 1 day per week in last 3 months associated with defecation, change in frequency of stool, change in the form of stool. (need at least 2 of these for IBS)
3
Q
IBS cause
A
- Unknown
- gut hypersensitivity
- contributing factors: genetics, motility factors, colonic infection (gastroenteritis), over growth of gut flora, psychological stress
4
Q
IBS-C
A
Type 1 or type 2 stool (hard >25%), loose stool (6/7) <25%
5
Q
IBS-D
A
Type 6/7 stool >25%, type 1/2 stool <25%
6
Q
IBS-M
A
both types >25%
7
Q
IBS-C treatment
A
- Lubiprostone (Amitiza) - more cl- secretion and motility
- Approved for women only
- Eat with food because of diarrhea and nausea
- Secretagogues (Linaclotide (Linzess) and Plecanatide (Trulance))
- SE: diarrhea, plecanatide has better side effects
- Tegasiod (zelmorm) -5HT agonist
- inc cardiac events so only use if emergency
- relabeled for use in women <65 with/out cardiac history (need <=1 CV risk factor)
- d/c if no benefit is seen within 4-6 weeks
8
Q
IBS-D treatment
A
- Rifaximin (Xifaxan) - abx, poorly absorbed
- SIBO (small intestinal bacterial overgrowth)
- 14 day course of therapy, can be repeated up to 2 more times with 1 year
-Eluxadoline (Viberszi)
-inhibits bowel contraction
-Sphinctor of oddi dysfunction (spasm)
CI: patients w/ hx of pancreatitis, alcoholism, ingest > 3 drinks per day, w/o gallbladder
- Alisetron (5-HT3 antagonist)
- only if patients fail 1st line
- severe constipation + ischemic colitis
- REMS program
- d/c therapy if no effect within 4 weeks
9
Q
IBS treatment any subtype
A
- antidepressants (TCA)
- amtriptyline
- nortriptyline (less sedation and anticholinergic effects)
- fiber soluble fiber - usually IBS-C
- soluble: oat bran, barley, beans - won’t worsen bloating
- non soluble: wheat bran, whole grain, veg - bloating/gas
