IBS (Irritable bowel syndrome) Flashcards by Rdouble Rdouble

What is irritable bowel syndrome?

Irritable bowel syndrome is a functional disorder.

How well did you know this?

Not at all

Perfectly

Is IBS a disease?

No IBS is not a disease

How well did you know this?

Not at all

Perfectly

Does IBS have one pathological entity?

No, IBS does not have a singular pathological entity

How well did you know this?

Not at all

Perfectly

What are significant triggers for IBS?

Gastroenteritis and stress are significant IBS triggers

How well did you know this?

Not at all

Perfectly

What is IBS a useful term for?

IBS is a useful term to classify patients who have similar medically unexplained symptoms.

How well did you know this?

Not at all

Perfectly

Which symptoms are NOT associated with IBS?

Symptoms NOT associated with IBS:
* Bleeding
* Abdominal pathology
* Masses
* Unexpected weight loss

How well did you know this?

Not at all

Perfectly

What are the key IBS characteristics?

IBS is characterised by pain (visceral hypersensitivity) and altered bowel habits.

How well did you know this?

Not at all

Perfectly

What is visceral pain?

Visceral pain:
pain emanating from the internal thoracic, pelvic, or abdominal organs.

How well did you know this?

Not at all

Perfectly

What is used for IBS diagnosis?

ROME IV criteria is used to diagnose IBS

How well did you know this?

Not at all

Perfectly

What is the Rome IV criteria based on?

The Rome IV criteria is based on symptoms

How well did you know this?

Not at all

Perfectly

How is Rome IV criteria diagnosis for IBS made?

Rome IV criteria diagnosis is done via exclusion and identification of symptoms

How well did you know this?

Not at all

Perfectly

What is the Rome IV criteria for IBS?

IBS Rome IV Criteria:
* Recurrent abdominal pain (at least 1 day/week in the last 3 months)
* + two or more of the following:
* Pain related to defaecation (increase or decrease)
* Stool frequency change
* Stool appearance change

How well did you know this?

Not at all

Perfectly

Does IBS affect men or women more?

IBS typically affects women more than men.

How well did you know this?

Not at all

Perfectly

What are the different Rome IV IBS classifications?

Rome IV IBS classifications:
* IBS-C (Predominant constipation)
* IBS-D (Predominant diarrhoea)
* IBS-M (Mixed diarrhoea & constipation)
* IBS- U (Unclassified)

How well did you know this?

Not at all

Perfectly

What seems to be the most prominent type of IBS?

IBS-D seems to be the most common type of IBS.

How well did you know this?

Not at all

Perfectly

Are IBS symptoms just linked to the lower bowel?

No IBS can have other symptoms including
* Functional dyspepsia
* Functional heartburn
* Bladder problems
* Headaches
* Backaches
* Unexplained muscle problems
* Gynaecological issues

Normal physiology witnessed in these areas*

How well did you know this?

Not at all

Perfectly

What other (non lower bowel related) symptoms are linked to IBS?

Non lower bowel related IBS symptoms:
* Functional dyspepsia
* Functional heartburn
* Bladder problems
* Headaches
* Backaches
* Unexplained muscle problems
* Gynaecological issues

How well did you know this?

Not at all

Perfectly

What is dyspepsia?

Dyspepsia term for recurring symptoms of an upset stomach that have no obvious cause.
Aka chronic indigestion

How well did you know this?

Not at all

Perfectly

Is IBS common?

IBS is very common up to 5-30% of population is affected

How well did you know this?

Not at all

Perfectly

What does morbidity mean?

Morbidity: the condition of suffering from a disease or medical condition

How well did you know this?

Not at all

Perfectly

Is there many effective medical treatments for IBS?

No, there aren’t many effective medical treatments for IBS

How much does IBS cost annually?

IBS costs are £45m annually direct

Does IBS cause direct mortality?

IBS does not cause direct mortality but it can cause severe morbidity.

What can cause mortality in IBS?

Drug therapy, medical interventions and procedures can cause mortality in IBS.

What causes IBS?

IBS causes: * Stress: gut is very responsive to emotional factors * Gastroenteritis

What is post infectious IBS?

Post infectious IBS is IBS that follows recovery from gastroenteritis (food poisoning). It is diarrhoeal predominant

Who does post infectious IBS affect the most?

Post infectious IBS affects young women more than men.

It is likely that IBS pathophysiology is linked to the ? and ?

It is likely that IBS pathophysiology is linked to gut hypersensitivity and brain hypervigilance

What are the relative risk factors for post infectious IBS?

Post infectious IBS risk factors: * Biological: Campylobacter infection (1:10, more likely than salmonella). * Psychological: Adverse life event in previous year (x2 more likely) * Sex: Females (x3.5 more likely) * Hypochondriacs (x2 more likely) * Having all 3 above factors makes someone 7x more likely.

What is the trigger of IBS in post infectious IBS?

Infection is the trigger in post infectious IBS but it is likely a combination of one of the relative risk factors as well as infection.

What does there need to be a better understanding of for IBS treatment?

There needs to be a better understanding of the mechanistic causes underlying IBS for treatment development.

Name some of the non-drug treatments for IBS

Non-drug IBS treatments * Low FODMAP diet * Support * Reassuarance * Explanation * Counselling * IBS groups

Name two types of drug treatments for IBS

IBS drug treatments: Analgesia (antispasmodic medicines, tricyclic antidepressants and selective serotonin reuptake inhibitors) Motility remedies (antidiarrhoeal and laxatives)

What are antispasmodic medicines?

Antispasmodic medicines: Reduce contractions in the GI tract

Name an antispasmodic medicine

Antispasmodic medicines: * Mebeverine hydrochloride * Alverine citrate * Peppermint oil capsules

What are tricyclic antidepressants?

Tricyclic antidepressants are anti depressants

What are analgesia?

Analgesia are pain killers

Analgesia used in IBS

Analgesia used in IBS: Antispasmodic medicines Tricyclic antidepressants Selective serotonin reuptake inhibitors

What is an example of a Selective serotonin reuptake inhibitors?

Selective serotonin reuptake inhibitor example: Fluoxetine Paracetamol

What is used for the treatment of IBS-D? (Diarrhoea predominant IBS)

IBS-D treatment 1st line: Dietary modification Anti-diarrhoeal drugs are used for the treatment of IBS-D. e.g .Loperamide

What is used for the treatment of IBS-C? (Constipation predominant IBS)

IBS-C treatment 1st line: Dietary modification Laxatives Ispaghula husk Osmotic laxatives May exacerbate some symptoms e.g bloating

What is a new drug effective for IBS-C?

New effective drug for IBS-C: Linaclotide * Agonist: Guanylate cyclase C * Laxative * Few side effects

What does Linaclotide do? (New IBS-C treatment)

Linaclotide: * Increases chloride secretion into lumen * Promotes fluid secretion into lumen * Blocks pain signalling * Promotes peristalsis

What is guanylate cyclase C?

Guanylate cyclase C: * Enterotoxin target * Regulates gut fluid secretion

What are FODMAPS?

FODMAPS: F:fermentable O:oligosaccharides D:disaccharides M:monosaccharides A: P:monosaccharides S:

What type of drugs need to be created for IBS?

Drugs that can target visceral pain are needed for IBS.

FODMAPS are **? **absorbed short-chain carbohydrates including fructose (in excess of glucose), lactose, polyols, fructans, and galacto-oligosaccharides.

FODMAPS are **poorly** absorbed short-chain carbohydrates including fructose (in excess of glucose), lactose, polyols, fructans, and galacto-oligosaccharides.

What is the FODMAP diet?

FODMAP diet * Temporary restrictive diet * Limit high FODMAP foods * Reintroduce them slowly to identify troublesome ones * Limit or avoid problem causing ones.

What is prucalopride?

What is linaclotide?

Linalotide: * Laxative * Guanylate cyclase-C agonist * New IBS-C treatment