IBS Flashcards
what is the cause in IBS
no organic cause can be found
when to diagnose IBS
abdominal pain relieved by defacation or associated with altered stool form or bowel frequency and 2 or more of: urgency, incomplete evacuation, abdo bloating/distension, mucous PR, worsening symptoms after food
other symptoms
nausea, bladder symptoms, backache
what are the symptoms
chronic, exacerbated by stress menstruation gastroenteritis.
signs
abdo tenderness general.
when should you do a colonoscopy to rule out other causes
> 50 years, or any marker for organic disease- temperature, blood PR, weight loss
what should you test if the diarrhoea is prominent
LFT, stool culture, b12/folate, anti endomysial antibodies (coeliac), TSH, rectal biopsy
when should you do an upper GI endoscopy
dyspepsia, reflux
small bowel radiology
crohns
duodenal biopsy
coeliac eg if anti endomysial antibiodies positive
giardia tests
giardia often triggers IBS
ERCP or MRCP
if active pancreatitis
management- diet
healthy diet. fibre, lactose, fructose, wheat, starch, caffeine, alcohol, fizzy drinks may make worse
treat constipation
avoid insoluble fibre. bisacodyl or sodium picosulfate. ispaghula, lactulose
treat diarrhoea
avoid sorbitol sweeteners, try bulking agent plus loperamide
