IBS Flashcards
What is IBS caused by?
Disturbance of gut brain interaction
What type of disorder is IBS?
Functional disorder
This means there is no identifiable bowel disease underlying the symptoms, and the symptoms result from the abnormal functioning of an otherwise normal bowel.
Who is IBS more common in?
Women
Young adults
What are the 3 key features of IBS?
• I – Intestinal discomfort (abdominal pain relating to the bowels)
• B – Bowel habit abnormalities
• S – Stool abnormalities (watery, loose, hard or associated with mucus)
What are some common symptoms of IBS? (8)
• Abdominal pain
• Diarrhoea
• Constipation
• Fluctuating bowel habit
• Bloating
• Worse after eating
• Improved by opening bowels
• Passing mucus
What can symptoms of IBS be triggered or worsened by? (9)
• Anxiety
• Depression
• Stress
• Sleep disturbance
• Illness
• Medications
• Certain foods
• Caffeine
Alcohol
What investigations must be done to exclude differential diagnosis when diagnosing IBS? (5)
FBC - anaemia
Inflammatory markers
Coeliac serology
Faecal calprotectin - IBD
CA125 - ovarian cancer
What is the criteria needed to diagnose IBS?
Differentials excluded
6 months or Abdo pain and discomfort
At least 1 of:
• Pain or discomfort relieved by opening the bowels
• Bowel habit abnormalities (more or less frequent)
• Stool abnormalities (e.g., watery, loose or hard)
Also require at least 2 of:
• Straining, an urgent need to open bowels or incomplete emptying
• Bloating
• Worse after eating
• Passing mucus
What lifestyle advice is given in IBS? (8)
• Drinking enough fluids
• Regular small meals
• Adjusting fibre intake according to symptoms (more fibre if predominantly constipated, less with diarrhoea/bloating)
• Limit caffeine, alcohol and fatty foods
• Low FODMAP diet, guided by a dietician
• Probiotic supplements may be considered over-the-counter (discontinuing after 12 weeks if there is no benefit)
• Reduce stress where possible
• Regular exercise
What is the first line medication for IBS with diarrhoea?
Loperamide
What is the first line medication for IBS and constipation?
Bulk forming laxatives e.g. ispaghula husk
Which medication is avoided in IBS and why?
Lactulose
Can cause bloating
What is the first line medication for cramps in IBS? Give examples? (5)
Antispasmodics
- mebeverine
- alverine
- hyoscine
- butylbromide
- peppermint oil
What is linaclotide?
a specialist secretory drug for constipation in IBS when first-line laxatives are inadequate.
What is loperamide used for?
Diarrhoea in IBS
