IBS Flashcards
What are they key symptoms of IBS?
Pain, bloating,
diarrhoea/constipation
Also often mucus, food triggers, flatulence
Incomplete stool evacuation
Change in bowel habit
Length of time need symptoms before diagnosis IBS
6 months
What disease to test for with IBS symptoms?
Coeliac
IBD
Management of IBS
Dietary advice:
Not too much time between meals
Cut out spicy foods, alcohol, triggers eg tomatos
Low FODMAP diet
Likely groups to have IBS
20-30 year old female
Genetic component - runs in family
Pathogenesis IBS
Abnormal smooth muscle -> GI function
Hypersensitivity to pain/viscera
Mental health/psychological link - anxiety
Colonic microbiota
Autonomic activity
Features of IBS
- Functional
- Chronic,relapsing
- Spectrumal
- Pain/discomfort - generalised and mobile
- Bloating
- 20-30 years
- 15% population, women more then men
Associated conditions IBS
Fibromyalgia, FBD, headaches, backaches, affective disorders - mood disorders
Treat IBS lifestyle
- Diet/nutrition
- Low FODMAP diet
- Regular meals
- Hydration
- Caffeine
- Alcohol
- Therapy on treating symptoms and how approach them - how process behaviours
- Dynamic/dialectical psychotherapies
- PTSD - approach very carefully, triggering
What is loperamide used for inIBS?
Diarrhoea
What does mebeverine do?
Antispasmodic
abdo pain and spasms
Linaclotide what does
Used whne other laxatives haevnt worked constipation
What laxative to acoid in IBS
Lactulose
RIsk factors for IBS
Genetic
Enteric infection eg GE
Dietary factors
Drugs - antibiotics
Pscyhcosocial
What investigations should be carried out in people with IBS
FBC, ESR, CRP, LFTs
Coeliac disease screening - TTG
CA-125
Fecal calprotectin - IBD
Why test for CA-125 in women?
Screen for ovarian cancer
If diagnosis unclear what investigations do for IBS
TFTs
US abdo
Colonsocpy
Faecal occult blood test
Faecal ova and parasite tests
H.pylori screen
When is a diagnosis of IBS considered time scale?
At least 6 months of
Abdo pain
Bloat
Change in bowel habit
When can IBS be considered on initial presentation?
Abdo pain relieved by defecation or ass w bowel frequency or stool form altering, + 2 of 4 form
Altered stool passage - strain, urgency, incomplete
Abdo pain, distension, hardness
Symptoms triggered by eating
Passage of mucus
(lethargy, nausea, back ache, bladder)
IBS ass conditions
Fibromyalgia, FBD, headaches, backahes, affective disorders, mood disorders
