IBS

Question 1

what is IBS?

Answer 1

irritable bowel syndrome

bowel symptoms with no organic cause

Question 2

what criteria is used in IBS?

Answer 2

Rome III criteria

Question 3

What are the presenting features of IBS?

Answer 3

abdo pain or discomfort for >12weeks in the last 6months 
with 2 of the following
- relieved by defecation 
- associated change in stool frequency
- associated change in stool consistency

Question 4

what are the 4 main subtypes of IBS?

Answer 4

diarrhoea predominant
constipation predominant
pain predominant
alternating pattern

Question 5

what tests should you do to rule out organic causes if you suspect IBS?

Answer 5

Blood: FBC, ESR, LFTs, coeliac serology, TSH

colonoscopy if >60yrs or any features of organic disease

Question 6

describe the management of IBS

Answer 6

reassure no serious bowel pathology
medical management: antispasmodics e.g mebeverine, hyoscine
antidepressants e.g. TCAs (lower doses than in depression)
diets and herbal remedies: exclusion diets can be tried, herbal drinks such as peppermint tea, bulking agents for constipation and diarrhoea e.g. Fybogel
CBT