IBS Flashcards
What is iBS?
Group of bowel disorders characterized by bloating and pain associated with defecation
OR
change in bowel habit where symptoms have lasted 6 months with symptoms at least 3 days per month in the last 3 months
What Causes IBS?
Motor or sensory dysfunction in the GI tract which alters gut reactivity and dysregulation of brain-gut axis
Can be associated with stress
Who gets it?
- Acute bacterial gastroenteritis
- Emotional stimuli
- TWICE as likely in women
- Fam history
Requirements of IBS?
Recurrent pain or discomfort which
+
-Improves with defecation
-is associated with change in form of stool,
- is associated with change in frequency of stool
Presentation of IBS?
- Diarrhoea
- Constipation
- Fluctuating bowel habits
- Abdominal pain
- Bloating
- Worse after eating
- Improved by evacuating bowels
Diagnosis of IBS?
Exclude if there is any organic disease (DIAGNOSIS OF EXCLUSION)
Gather history and examination
Normal FBC, if no red flags and under 50
How is IBS treated?
Diet modifications: fibre, caffeine, regular meals, food diary
Exercise
Reducing stress
Medication
Medications to treat IBS?
Anti-spasmodics - reduce pain & cramping
Laxatives: relieve constipation
Anti-motility: relieve diarrhoea
Low dose antidepressants: can reduce stomach pain & cramping
Reduce/stop opioid analgesics
Criteria for diagnosis- What should be excluded?
- Normal FBC, ESR & CRP blood tests
- Faecal calprotectin negative to exclude IBD
- -ve coeliac serology (TTG)
- Cancer not suspected
Criteria for diagnosis- symptoms suggesting IBS?
3 month history of abdominal pain and/or discomfort for atleast 3 days per week that is:
- Relieved on defaecation
- Associated with change in stool frequency
- Associated with change in stool consistency
Medication for diarrhoea?
Loperamide is first line
