IBS

Question 0

What are Discrete Clustered Contractions (DDCs)?

Answer 0

Can correlate with obstruction
seen in IBS
not very painful

Question 1

Prolonged Propogated Contractions (PPCs) are what? Where do they occur?

Answer 1

aka Abdominal Cramps that occurs in IBS

Occurs in ileum

Question 2

Disregulation of brain-gut axis (autonomic nervous system) causes what

Answer 2

spasms of GI smooth muscle

abdominal pain

Question 3

Diagnostic criteria for IBS

Answer 3

recurrent abdominal pain for at least 3 days per month in last 3 months along with 2 of the following:

Improves with defecation***
Onset associated with change in frequency of stool
Onset associated with change in appearance of stool

Question 4

Red flags in diagnosis of IBS

Answer 4

physical: fever, occult stool +
historical: weight loss, older, nocturnal awakening, IBD history
labs: decreased Hgb, increased WBC, increased ESR

Question 5

Drugs to relieve pain of IBS

Answer 5

antispasmodics
anticholinergics
Ca++ antagonist

Question 6

Drugs to treat diarrhea

Answer 6

Loperamide
Diphenoxylate
Cholestyramine

Question 7

Drugs to treat constipation

Answer 7

Fiber
Osmotic laxatives
Cisparide
Misoprostil
PEG solution

Question 8

Two serotonin drugs for IBS

Answer 8

for IBS-Diarrhea, ALOSETRON (serotonin 3 receptor agonist). reduces perception of pain, induce rectal relaxation, delay colonic transit.

for IBS-Constipation, MISOPROSTIL (serotonin 4 receptor ANTAGONIST), prokinetic, stimulates peristalsis

Question 9

Psychological therapies for IBS

Answer 9

antidepressants: tricyclics for IBS-D, SSRI for IBS-C