IBS Flashcards
What is IBS?
Functional bowel disorder
What does a functional bowel disorder mean?
- No identifiable organic disease
- Diagnosis of exclusion
What percentage of the population have IBS?
20%
Which gender is most commonly affected?
Women
How does IBS present?
- Abdo pain/bloating
- Diarrhoea/constipation (Fluctuates)
What relieves the pain in IBS?
Opening bowels
What worsens the pain in IBS?
Eating
What must be unremarkable for a diagnosis of IBS?
- Full profile
- Faecal calprotectin
- anti-TTG antibodies
What must be present for IBS to be diagnosed?
- Abdo pain with bowel habit change
and 2 of:
- Bloating
- Eating exacerbates
- abnormal stools
- mucus in stools
How is IBS conservatively managed?
- Regular small meals
- Limit caffeine and alcohol
- Low FODMAP diet
- Probiotics
What is FODMAP?
Short-chain carbs
What medications are first line in IBS?
Loperamide- diarrhoea
Linaclotide/laxative- constipation
Buscopan- cramps
What is the active drug in Buscopan?
Hyoscine butylbromide
What are the second and third line meds in IBS?
2nd- tricyclicanti-depressants (amitryptyline)
3rd- SSRIs
How is CBT used in IBS?
Reduce the stress associated with the symptoms
What is the principle of IBS management?
Find the patients’ preferred state between diarrhoea and constipation
What does this describe?
‘Sometimes I get bloated. It can last several days, and if I go to sleep bloated, I will wake up bloated.’
IBS
What does this describe?
‘When I wake up, my tummy is flat. As I go through the day, it gets more bloated. When I go to sleep, it will flatten again.’
Constipation
What is constipation overflow and how does it present?
Watery diarrhoea
- Constipation promotes the release/leak of water into the GI lumen to flush it/go around the blockage
- Do not use anti-diarrhoeals e.g. loperamide with this
