IBS

Question 1

T or F. Abdominal pain is required for the diagnosis of IBS

Answer 1

T.

Question 2

T or F. IBS is no longer a diagnosis of exclusion

Answer 2

T. Like all functional GI disorders, IBS is more in women

Question 3

note that the pain of peptic ulcer disease is normally improved by eating, while the pain of functional dyspepsia is typically made worse by eating

Question 4

Answer 4

Ddx: IBS-D (abdominal pain and change in bowel habits required!), cancer very unlikely, parasite/infection, Celiac disease (should test her if shes not restricting gluten), hyper-thyrodism, IBD??

Question 5

If this does happen to be IBD, would it be UC or CD?

Answer 5

CD (Not UC b/c no blood!- diagnosis of UC REQUIRES blood in stool)

Question 6

Probiotics are unlikely to work

Enzymes will be digested in the stomach!! Dont work AT ALL

Answer 6

Maybe dont need to do much

Colonoscopy wont really offer much. if she has rectal bleeding of fam Hx of CRC, definitely need one

Blood test for celiac and stool studies probably a good idea

Might also want to check thyroid, and CBC

Question 7

Pt. 1

Answer 7

Can now rule in using the Rome criteria

Question 8

No blood tests, imaging for dignosis so mostly clinically

Question 9

Stress doesnt CAUSE this.. but might make it worse

Note the hyocyamine- good for post-prandial pain and diarrhea (its an anticholinergic)

Answer 9

TCAs can be used at lower dose than that for depression, but dont work instantly. TCAs have some anti-cholinergic activity (only use in IBS-D)

Question 10