IBS

Question 1

What’s re the symptoms of IBS? (7)

Answer 1

Diarrhoea 
Constipation 
Fluctuating bowel habit
Abdo pain
Bloating
Worse after eating 
Improved by opening bowels

Question 2

What investigations can be done that rule out other causes in IBS? (4)

Answer 2

Normal FBC, ESR and CRP

Normal faecal calprotectin

Negative anti TTG antibodies for coeliac

Negative cancer investigations or history

Question 3

What are the symptoms that suggest IBS? (2 main symptoms and 4 secondary symptoms)

Answer 3

Main symptoms:
Abdo pain relieved by opening bowels
Abdo pain associated with change in bowel habit

And 2 of:
Abnormal stool passage
Bloating
Worse after eating 
PR mucus

Question 4

What is the lifestyle adviceof IBS? (6)

Answer 4

Adequate fluid intake

Regular small meals

Reduced processed foods

Limit caffeine and alcohol

Low “FODMAP” diet

Trial of probiotic supplements for 4 weeks

Question 5

What are the first line medications for IBS? (3)

Answer 5

Loperamide (diarrhoea)

Laxatives (constipation) avoid lactulose as it causes bloating

Antispasmodics (cramps) e.g hysoscine butylbromide (Buscopan)

Question 6

What is the second line medical treatment for IBS?

Answer 6

Tricyclic antidepressant like amitriptyline

Question 7

What is the third line medication for IBS?

Answer 7

SSRI’s