IBS W7

Question 1

IBS diagnostic criteria?

Answer 1

Rome IV criteria:
abdominal pain and 2 of:
-related to defaecation
-change in stool frequency
-change in stool form

Question 2

mechanism of pain in IBS?

Answer 2

evidence for abnormal:
-motor function
-peripheral sensory function
-spinal processing
-central processing
-cortical activation
-descending CNS modulation

Question 3

IBS subtypes?

Answer 3

IBS-C = constipation

IBS-D = diarrhoea

IBS-M = mixed

IBS-U = neither category

Question 4

IBS symptoms?

Answer 4

onset following gastroenteritis
post-prandial urgency
alternating diarrhoea/constipation
passing mucus
sensation of incomplete evacuation
abdominal bloating and distention

Question 5

other conditions associated with IBS?

Answer 5

migraine
dyspepsia (indigestion)
dyspareunia (painful sex)
bladder problems
fibromyalgia (widespread MSK pain)
chronic fatigue

Question 6

alarm features that suggest other diagnosis? (IBS)

Answer 6

weight loss
rectal bleeding
anaemia, thrombocytosis
persistent diarrhoea
new onset over 50 yrs
frequent nocturnal symptoms
FHx bowel cancer/IBD

Question 7

IBS maangement?

Answer 7

first line = lifestyle advice

altered diet
drug therapy
psychological therapies (eg CBT)

Question 8

most common drug for constipation?

Answer 8

macrogols