IBS Flashcards
What is IBS?
A common, chronic, relapsing and often life-long condition associated with altered bowel habit and bowel discomfort
Which age group is IBS most prevalent?
20-30 year old women
Symptoms of IBS
Abdominal pain, diarrhoea or constipation, urgency, incomplete defaecation and passing mucus
Factors which exacerbate IBS
Coffee, alcohol and milk
Large meals
Fried foods
Stress
Non-drug treatment
Increase exercise
Eat regular meals without long gaps between
Reduce fresh fruit consumption to 3 portions per day
Reduce insoluble fibre e.g., bran and resistant starch
Increase soluble fibre e.g., oats
Drink at least 8 cups of water daily
Reduce caffeine, alcohol and fizzy drinks
Avoid sorbitol if you have diarrhoea
Reduce stress
Probiotics for at least 4 weeks
Drug treatment
Antispasmodics: alverine, mebeverine, and peppermint oil
Laxatives: if constipated
Loperamide: if experiencing diarrhoea
Antimuscarinic: hyoscine butylbromide
When should hyoscine butylbromide be avoided?
In cardiac disease
Which laxative should not be offered to IBS patients?
Lactulose as it may cause bloating
Treatment for patients who have not responded to laxatives from the different classes who have had constipation for at least 12 months
Linaclotide
Treatment of IBS if OTC therapy fails
Low-dose amitriptyline for abdominal pain or discomfort
SSRI if TCA doesn’t work (unlicensed)
Classifications of antispasmodics
Antimuscarinics and Smooth Muscle Relaxants
Examples of antimuscarinic antispasmodics
Atropine sulfate
Discylcoverine hydrochloride
Propantheline bromide
Hyoscine butylbromide
Which antimuscarinic antispasmodics are less lipid soluble? What is the effect of this?
Propantheline bromide
Hyoscine butylbromide
Less likely to cross the BBB = lower risk of CNS side effect
Examples of direct acting intestinal smooth muscle relaxants
Alverine citrate
Mebeverine hydrochloride
Peppermint oil
