IBS Flashcards

1
Q

What is the Rome Diagnostic criteria for IBS?

A
  • recurrent abdominal pain/discomfort for 3 days of the month

Assoc. with:

  • improves with defecation
  • change in stool freq.
  • change in form/appearance of stool
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2
Q

If a patient presents with symptoms of IBS, what other criteria would make you investigate further?

A

Further evaluation if >50 or has any of:

- weight loss
- blood in stools
- anaemia
- fever
- short history of progressive pain
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3
Q

What is involved in the Manning criteria for IBS?

A
  • pain relieved on defecation
  • more freq. and looser stools at onset of pain
  • visible bloating/ abdominal distension
  • passage of mucus
  • tenesmus (feels incomplete)
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4
Q

What investigations would you consider doing for patients who present with symptoms of IBS?

A
  • inflammatory markers (PV/ CRP)
  • TTG (coeliac)
  • faecal calprotectin
  • AXR in selected people
  • H+ breath test
  • cross sectional imaging
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5
Q

What dietary measures are recommended for the treatment of IBS?

A
  • healthy intake of fruit and vegetables
  • skins and seeds may irritate symptoms
  • Some foods may ferment gas/ bloating/
    pain (e.g. pulses, onions, garlic, mushrooms)
  • If it upsets you, don’t eat it
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6
Q

Give examples of antispasmodics which can be used in IBS?

A
  • Mebeverine (Colofac)
  • Alverine citrate (Spasmonal)
  • Peppermint oil (Colpermin) - decreases bloating
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7
Q

How is fibre added to the diet in patients experiencing IBS?

A
  • bran fibre often ineffective

=> soluble fibre supplements effective:
E.g. ispaghula (Fybogel)

  • absorb water to bulk up stool
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8
Q

Osmotic laxatives do not help symptoms of pain in IBS. TRUE/FALSE?

A

TRUE

  • prevents water absorption
  • improves constipation but not pain
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9
Q

Stimulant laxatives should be avoided in IBS patients/ TRUE/FALSE?

A

TRUE

  • avoid
  • only infrequent short term use
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10
Q

What anti-diarrhoeals can be used in IBS?

A

loperamide

- reduces stool frequency
- improves consistency

codeine phosphate

- effective
- should be avoided if dependence
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11
Q

What antidepressants can be used in IBS?

A
  • tricyclics (amitriptyline, nortriptyline)

- SSRI’s

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12
Q

What anti-convulsant analgesics can be used in IBS?

A

gabapentin

pregabalin (beneficial in anxiety component)

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13
Q

Why are pro-biotics thought to be useful in IBS?

A
  • to alter the gut microbiota
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14
Q

What psychological and alternative therapies can be used for IBS treatment?

A
  • CBT
  • dynamic psychotherapy
  • hypnotherapy
  • Herbal remedies
  • acupuncture
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