IBS, UC, Chron's Disease - Chapter 22 Flashcards
Irritable Bowel Syndrome (IBS)
A condition that causes:
- Abdominal distress or erratic movement of large bowel leading to decreased quality of life
- IBS with diarrhea predominance (IBS-D)
- IBS with constipation predominance (IBS-C)
- IBS with alternating diarrhea/constipation (IBS-A)
- symptoms before 35
- NOT inflammatory
- Movement of waste through colon too slow or too rapid
What causes IBS
- food allergies or sensitivities
- Stress
- Antibiotic use
- Chronic alcohol use
- Bile acid malabsorption
- Abnormally low levels of serotonin
Inflammatory Bowl Disease (IBD)
- A chronic and serious autoimmune inflammatory condition of the GI tract causing severe diarrhea, abdominal cramps, rectal bleeding, fever, joint pain, loss of appetite, fatique, bowel obstruction, etc.
- Includes ulcerative colitis, Chron’s disease, ulcerative proctitis, and indeterminate colitis
Causes of IBD
- May be caused by a combination of genetic factors and/or environmental conditions that trigger the autoimmune response
- During the autoimmune response Tumor Necrosis Factor (TNF) and other antiinflammatory substances are released to fight the “infection” and cause inflammation, ulceration and pain
Colonoscopy and sigmoidoscopy
-IBS can be ruled out and ulcerative colitis or Chron’s disease can be diagnosed by testing stool samples, taking radiographs, and performing a colonoscopy or sigmoidoscopy
IBD: Ulcerative Colitis (UC)
- UC produces inflammation, ulcers and sores in the upper layers of the lining of the colon and rectum
- Inflammation is limited to the colon and rectum rather than other areas of the GI tract
- Most commonly occurs between ages of 15-45
IBD: Chron’s Disease
- Chron’s disease may cause chronic inflammation and ulceration of the entire GI tract
- Inflammation and ulcers are DEEP within the intestinal wall
- Most common in ages 15-45
Similar Symptoms Between IBS, UC, and Chron’s Disease
- Abdominal Pain
- Diarrhea
- Cramping
Disease specific Symptoms: IBS
- Erratic bowel movements
- Abdominal pain relieved by having a bowel movement
- Bloating
- Constipation
Disease Specific Symptoms: UC
- Rectal bleeding
- Anemia
- Weight loss/loss of appetite
- Fatigue
- Loss of vitamins and minerals
- Skin lesions
- Joint pain
- Fever
Disease Specific Symptoms: Chron’s Disease
- Rectal bleeding
- Anemia
- Weight/appetite loss
- Loss of vitamins and minerals
- Skin lesions
- Joint pain
- fever
Drugs Used in the Treatment of IBS
- Opioid antidiarrheals
- Laxatives
- Bulk forming Fiber supplements
- Anticholinergics/antispasmodics
- Misc agents
- 5-HT4 agonist
- guanylate cylase-C agonist
Opioid Antidiarrheals
-Control watery and frequent stools of IBS
Antidiarrheals Examples
- attapulgite
- bismuth subsalicylate
- cholestyramine
- diphenoxylate/atropine
- loperamide
Generic: attapulgite
Kaopectate
Generic: bismuth subsalicylate
Pepto Bismol
Generic: cholestyramine
Cholestyramine
Generic: diphenoxylate/atropine
Lomotil
- Narcotic
- Opioid antidiarrheal
Warning Labels
- MAY CAUSE DIZZINESS AND DROWSINESS
- AVOID ALCOHOL
- TAKE WITH LOTS OF WATER
Generic: loperamide
Imodium
-Opioid antidiarrheal
Warning Labels
-TAKE WITH LOTS OF WATER
Opioid Antidiarrheals ADR”s
- Sedation (Lomotil)
- Constipation
- Toxic megacolon
Laxatives
-Used in moderation for alleviating constipation of IBS
Stimulant Laxatives Examples
- bisacodyl
- sennosides
Generic: bisacodyl
Carters Little Pills
Correctol
Dulcolax
-Stimulant Laxative
Generic: sennosides
Senokot
Ex-Lax
-Stimulant Laxative
Osmotic Laxatives Examples
- PEG-3350
- electrolytes/PEG-3350
- lactulose
- magnesium citrate
- magnesium hydroxide
- magnesium sulfate
- picosulfate sodium/magnesium oxide/citric acid
- sodium phosphates
Generic: polyethylene glycol (PEG-3350)
Lax-A-Day
RestoraLAX
-Osmotic Laxative
Generic: electrolytes/PEG-3350
Colyte Moviprep Kleanprep Bi-Peglyte Peglyte Golytley
-Osmotic Laxative
Generic: lactulose
lactulose
-Osmotic Laxative
Generic: magnesium citrate
Citro-Mag
-Osmotic Laxative
Generic: magnesium hydroxide
Milk of Magnesia
-Osmotic Laxative
Generic: magnesium sulfate
magnesium sulfate
-Osmotic Laxative
Generic: picosulfate sodium/magnesium oxide/citric acid
Pico-Salax
Picoflo
-Osmotic Laxative
Generic: sodium phosphates
Fleet Enema
Fleet Phospho-Soda Oral Laxative
-Osmotic Laxative
Bulk-Forming Fibre Supplements
- Soluble fibre supplements relieve constipation and diarrhea of IBS
- Swell in the presence of liquid
- Increase bulk or firmness of stool in patients with diarrhea