IBS and FODMAP

Question 1

What are functional Gut Disorders?

Answer 1

They are disorders of function (how the GI tract works), not structural or biochemical abnormalities.

Can affect any part of the (GI) tract,
• Oesophagus
• Stomach
•Intestines.

Question 2

What is IBS?

Answer 2

Irritable Bowel Syndrome:

The most common FGID, Characterised by;

• Chronic or recurrent symptoms
• Lower abdominal pain
• Related to bowel movements
• Some relief of pain after defecation
• Non life threatening , do not damage GI lining or cause cancer
• However significant impact of QoL

Question 3

What are the symptoms of IBS?

Answer 3

Change in bowel habit
• Diarrhoea – IBS-D
• Constipation – IBS C
• Alternating – IBS M
• Unspecified – IBS-U
•Sense of incomplete rectal evacuation
•Passage of mucous with stool
•Abdominal bloating /distention

Question 4

What causes IBS?

Answer 4

Aetiology mainly unknown, although there is triggers in susceptible individuals;

• Infection
• Food intolerance
• General diet
• Emotional stress
• Medication

Question 5

What are the three main Pathophysiology effects of IBS?

Answer 5

• Motility
• Sensation
• Brain Gut Dysfunction

Question 6

How is IBS diagnosed?

Answer 6

•Diagnosis predominantly based on
symptoms
• Symptoms change overtime or overlap
• Type of symptoms
• Frequency
• Duration

If alarm features present additional
tests

Question 7

Describe tests used to check for alarm features?

Answer 7

• Coeliac serology
• Fe studies
• Vit b12
• Folate
• TFT
• Calprotectin
• Stool Cultures
• Chem 20
• FBE

Question 8

What is the First Line management for IBS?

Answer 8

• Limiting
• Alcohol
• Caffeine
• Spicy foods
• Fatty and rich foods
• Eating smaller meals

Check for
• Fibre intake
• Fluid
• General healthy eating, participating in regular physical
exercise

Question 9

What is the Second Line management for IBS?

Answer 9

•Low FODMAP DIET

The Term FODMAP’s refers to a collection of short-chain fermentable carbohydrates that are poorly absorbed and cause digestive discomfort in some people.

It involves three phases called;

Restriction: 2-6 weeks

Reintroduction: 8-12 Weeks

• 1 FODMAP at a time
• One Food at a time
• Over 3 days

Personalisation: You will learn what you can and cannot eat for the long term.

Question 10

Possible PESS Statements:

Answer 10

(1): Altered GI function related to suboptimal dietary patterns (inadequate fibre and fluid intake, nil regular meals) and possible food intolerances evidenced by diet history and reported symptoms (diarrhoea, constipation, bloating cramping, abdo pain)

(2):Altered GI function (diarrhoea) related to suspected food intolerances, as evidenced by diet and clinic hx pt
reporting improvement in sx with current medication
regime + lower FODMAP diet

Question 11

What are some examples of High and Low FODMAP Foods?

Answer 11

High FODMAP: Wheat, Apples, apricots, cherries, figs, mangoes, nectarines, peaches

Low FODMAP: Brown rice, quinoa, Unripe bananas, blueberries, kiwi, limes, mandarins, oranges