IBS

Question 1

Give the Rome III diagnostic criteria for IBS

Answer 1

Recurrent abdominal pain/discomfort for at least 3 days per month for 3 months and 2 of the following:

• Improvement with defecation
• onset associated with changes in stool frequency
• onset associated with changes in stool form (appearance)

Question 2

Who tends to be affected more from IBS?

Answer 2

Females 2:1 males

Question 3

How is IBS described?

Answer 3

Chronic relapsing problem with a spectrum of symptoms but no operations are available and it will not affect the longevity of life

Question 4

Symptoms of IBS

Answer 4

Abdo pain 
Bloating
Change in bowel habits (diarrhoea/constipation/mixed)
urgency 
tenesmus 
aggravated by stress/menstruation

Question 5

Alarm features of IBS

Answer 5

Age >50
FH of CRC
Short duration of symptoms 
woken from sleep for the toilet 
PR bleeding 
weight loss 
anaemia

Question 6

Investigations for IBS

Answer 6

FBC
ESR
CRP
TTG antibody testing for coeliac disease

Question 7

Non-pharmacological treatment for IBS

Answer 7

regular meal times

reduce fibre intake

Question 8

Pharmacological treatment for IBS

Answer 8

Stop opiate analgesia
Anti-diarrhoeals - Loperamide
Anti-spasmodics - Buscopan, Mebeverine
Antidepressants - Tricyclics eg. Amitriptyline (reduces diarrhoea, restores sleep pattern, reduces afferent signals from gut - less pain)

Question 9

What are the non colonic features of IBS?

Answer 9

Dyspareunia and urinary frequency

Question 10

What is the venous drainage of the colon?

Answer 10

Sigmoid veins to inferior mesenteric veins