IBS Flashcards
What is IBS?
A chronic functional disorder of the Gl tract:
chronic abd pain and altered bowel habits in the absence of an organic disease
possible etiology of IBS?
Visceral hypersensitivity Altered bowel motility Neurotransmitters imbalance Infection Psychosocial factors
sxs of of IBS?
Abd pain Distention Bloating Indigestion Various symptoms of defecation
3 subcategories of IBS?
pain assoc. with diarrhea
pain assoc. with constipation
pain and diarrhea/constipation
conditions assoc. with IBS?
HA, sleep disturbances, musculoskeletal CP, nausea, heart burn, back pain
Tx of IBS?
diet/lifestyle
low FODMAP diet
exclude foods that increase flatulence: ETOH, caffeine, +/- lactose/gluten
exercise
Pharm tx for predominant diarrhea IBS?
Initial: antidiarrheal agents, especially loperamide
Pharm tx for predominant constipation IBS?
Initial: fiber supplements may lead to softening of stools and reduced straining
Pharm tx for IBS-C
Failed a trial of soluble fiber:
psyllium/ispaghula
Trial of polyethylene glycol (PEG)
Alternatives: lubiprostone or linaclotide
what is polyethylene glycol?
PEG is an osmotic laxative
improves constipation but not abd pain
Dosing of PEG?
Initially start with 17 g of powder dissolved in 8 ounces of water once daily and titrate up or down (to a maximum of 34 g daily) to effect
ADEs of PEG?
bloating and abdominal discomfort limit the use
Name a chloride channel activator
Lubiprostone
