IBS (2) Flashcards
What is it?
Who is it more common in?
➊ Abdominal symptoms w/no organic cause
➋ Younger Women
What are its diagnostic criteria?
Which symptoms point towards other organic disease?
What are its differentials?
How is it investigated?
➊ Abdominal pain/discomfort that is either relieved by defecation OR associated with altered bowel habits, PLUS 2+ of:
• Bloating
• Symptoms made worse by eating
• Altered stool passage (e.g. straining, urgency, incomplete emptying)
• PR mucous
➋ PR bleeding, Weight loss, Fever
➌ • IBD
• Coeliac disease
• Cancer
➍ Aim to rule out the other organic differentials:
• Faecal Calprotectin, FBC, CRP/ESR - rule out IBD
• Coeliac screen - anti-TTG igA, anti-Endomysial
Management:
What is important to mention to the pt on diagnosis?
What is the lifestyle advice to give?
What can be given for symptomatic relief?
➊ Making a positive diagnosis and providing reassurance that it isn’t a serious pathology
➋ • Stay hydrated
• Regular, small meals
• Less alcohol and caffeine
• Change diet - refer to dietician
➌ • 1st line - Loperamide, Laxatives, Antispasmodics (e.g. mebeverine hydrochloride, buscopan)
• 2nd line - Amitriptyline
• 3rd line - SSRIs
