Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

GI > IBS + constipation > Flashcards

IBS + constipation Flashcards

1
Q

What causes IBS

A

Unknown cause related to gut sensitivity and altered motility
No inflammation or damage to bowel

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What brings IBS on

A 
Stress
Anxiety
Depression
Emotional distress 
Menstruation
Gastroenteritis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the S+S of IBS

A 
Rome Criteria 
Abdominal pain +2 of 
Relief by defaecation
Altered frequency
Altered form - Constipation or Diarrhoea 
>6 months 
Other 2/4
Urgency / straining 
Incomplete evacuation 
Bloating 
Worse by eating 
Mucous / bleeding in stool
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is characteristic of IBS abdominal pain

A 
Radiate to back 
Vague 
Burning 
Altered by bowel action
Rare at night  
Non-cyclical (endometriosis can mimiic)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are other features

A

Lethargy
Nausea
Backache
Bladder issues

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What investigations do you perform in IBS

A

Clinial with Rome criteria if no red flag

Bloods - FBC, ESR, CRP, coeliac if classic Hx to exclude +- calprotectin + stool culture (in GP)
VE and abdo exam
Urea breath test

Colonoscopy if 60+ / alarm symptoms
Refer if FH ovarian / bowel

Consider clinical context but don't do regularly 
Thyroid
Coeliac serology
Ca-125 
Stool culture
Calprotectin 
Rectal examination 
FOB
B12 deficiency
Hydrogen breath
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is calproctectin

A

Marker of inflammation in mucosa
Detects neutrophils in the stool
Differentiates IBD and IBS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How do you treat IBS non-pharmacological

A

Dietic review - FODMAP, lactose, gluten
Exercise
Reduce stress
Psychotherapy if refractory >12 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

How do you treat pain in IBS

A

Anti-sposmodics - Buscopan for colicky pain

Antidepressants - TCA 2nd line or SSRI (also if refractory)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How do you treat bloating

A

Probiotics

Avoid fibre and bulking agents

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

How do you treat constipation

A

Laxatives
- 5HT4
Avoid FODMAP
Water + fibre

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How do you treat diarrhoea

A

Anti-motility agent - loperamide = 1st line
FODMAP
Avoid caffeine / alcohol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are alarm symptoms in IBS requiring colonoscopy

A 
50+ as unlikely to have IBS 
Short history <6 months 
Recent change in bowel habit 
Weight loss
Nocturnal symptoms 
Male 
FH Bowel / ovarian ca / IBD 
Mouth ulcers 
Anaemia
Abnormal CRP 
Rectal bleeding
Abdominal mass or LN 
\+e FOB 
Recent antibiotic use as decreased diversity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What drugs cause constipation

A 
Opiates
Anti-cholinergic 
Iron 
Diuretic
CCB
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are neurogenic causes of constipation

A 
Neuropathy
Parkinson's
Stroke
MS
Spinal cord injury
Systemic sclerosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are organic causes

A 
Strictures
Malignancy 
Diverticulitis 
IBD
Fissure
Prolapse 
Obstruction 
Psuedo-obstruction after operation
Gastrostasis due to DM 
Hisprung;s
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are systemic causes of constipation

A

Diabetes
Low thyroid
Hyper-calcium
Hypokalaeimia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are functional causes of constipation

A 
Mega colon
Depression
Psychosis 
Pain 
No toilet
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are other causes of constipatio

A 
Lack of fibre
Lack of exercise
Unhealthy BMI
Dehydrated
Age 
Hospital / post-op
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

How do you Dx constipation

A 
DRE to look for impaction 
Bowel sounds
Abdo exam 
FBC, ESR, U+E, Ca, TFT 
Colonoscopy if suspected malignancy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

How do you treat constipation

A

Lifestyle advice - drink more, high fibre
Diet advice
Bulking agent e.g. fibrogel
Oral laxative
Suppository - push past stool
Phosphate Enema - useful if impacted before using laxative (water)

22
Q

What are complications of constipation

A 
Haemorrhoids
Faecal impaction
Overflow incontinence 
Acute urinary retention 
Delerium
23
Q

What is 1st line laxative

A

Stimulant e.g. senna to increase motility

24
Q

What is 2nd line

A 
Add laxido (movicol) - isotonic 
1st line in kids
25
Q

What is next line

A

Osmotic = lactulose to retain fluid - may need if long standing and stools very hard
- Need to drink lots

26
Q

What are other options

A

Pro-kinetic drugs
Metaclopramide (D2) - useful in pseudo
Azithromycin

27
Q

When is metaclopramide CI

A

Obstruction as risk of perforation

28
Q

What do you do for gastroporesis

A 
NBM
NG tube 
TPN if longer
Change meds to IV if NG tube 
Depact colon
29
Q

What does laxative abuse cause

A

Melanosis coli

Pigetned laden macrophages

30
Q

What suggests further investigation

A

Weight loss
MASS
PR Blood
Anaemia

31
Q

What is constipation

A 
<3 stool a week
Difficulty passing
Pain
Bloating
Incomplete
32
Q

What shows degree of obstruction

A

Can they pass wind

33
Q

What is small bowel overgrowth syndrome

A

Excessive amounts of bacteria in small bowel

34
Q

How does it present

A 
Chronic diarrhoea
Bloating
Flatulence
Abdoinal pain
Similar to IBS
35
Q

Who is at risk

A 
Neonates with GI abnormality
Scleroderma 
Systemic sclerosis 
DM
Gastrectomy
Hypothyroid
36
Q

What is 1st line test

A

Hydrogen breath test

37
Q

How else do you Dx

A

Small bowel aspiration and culture = diagnostic
Stool culture
Bile acid breath
Endoscopy

38
Q

How do you treat

A

Ax?
Rifaximin
Mettronidazole
Co-amox

39
Q

What does obesity cause

A 
Gall bladder disease
Pancreatitis
NAFLD
GORD
Cancer
Hypertension
Heart disease
Stroke
40
Q

What is normal BMI

A

18.5-25

41
Q

What is overweight

A

25-30

42
Q

What is obese

A

30+

43
Q

What is underweight

A

<18.5

44
Q

What are options

A

Gastric band
Gastric bypass
Sleeve gastrectomy

45
Q

What is gold standard

A

Combination - roux en y bypass

46
Q

What does a gastric band do

A

Decrease size of stomach by a band
Minor op
Reversible
Risk of prolapse

47
Q

What does a bypass do

A

Bypass segments of bowel
Leads to quick weight loss
Dumping syndroe
Malabsorption

48
Q

What does a sleeve gastrectomy do

A

Removes past of stomach
More invasive
No dumping syndrome or foreign body

49
Q

What are the complications of gastric surgery

A 
Anastomotic leak
DVT / PE
Infection
Malnutrition
Vitamin deficiency 
Hair loss 
Dumping
50
Q

What needs excluded if IBS Sx + >50

A

Ovarian cancer

GI (29 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions