IBS - Week 4

Question 1

IBS is characterised by…

Answer 1

Abdominal pain/bloating

Question 2

At which age does IBS usually present?

Answer 2

30s-40s

Question 3

Is IBS more common in women or men?

Answer 3

Twice as likely in women

Question 4

What are the 3 types of IBS?

Answer 4

IBS-C, IBS-D, IBS-M

Question 5

IBS with constipation is called…

Answer 5

IBS-C

Question 6

IBS with Diarrhoea is called…

Answer 6

IBS-D

Question 7

IBS with a mix of constipation and diarrhoea is called..

Answer 7

IBS-M

Question 8

Give some signs which would show that IBS is progressing.

Answer 8

• In wheelchair due to pain
• Given up work due to pain
• Wears dark glasses
• Carries bottle of water
• Drinks from bottle of water during interview

Question 9

What is the cause of IBS?

Answer 9

Genes/Environment

Question 10

Scientifically, what is the cause of IBS?

Answer 10

Visceral hypersensitivity

Question 11

What is meant by ‘visceral hypersensitivity’?

Answer 11

Pain is felt to a much greater extent than would be expected

Question 12

Central hypersensitivity in IBS may be caused by a condition such as…

Answer 12

Fibromyalgia

Question 13

Peripheral hypersensitivity in IBS may be caused by…

Answer 13

Gastroenteritis

Question 14

Which criteria is used for diagnosing IBS?

Answer 14

Rome III

Question 15

What are the criteria in Rome III?

Answer 15

Recurrent abdo pain/discomfort - at least 3 days/month
Change with defecation
Onset associated with change in stool frequency
Onset associated with change in stool appearance

Question 16

Give some associated conditions of IBS.

Answer 16

Fibromyalgia, TMJ dysfunction, chronic pelvic pain, chronic fatigue syndrome, overlap with severe IBS and psychiatric problems

Question 17

Give some triggering factors of IBS.

Answer 17

Stress, codeine and opiate/narcotics, infection, menstruation

Question 18

Give some alarming features of IBS that would prompt further investigation.

Answer 18

Short duration of symptoms 
Woken from sleep
Rectal bleeding
Weight loss
Anaemia
FH of colorectal cancer
Recent antibiotics

Question 19

What are the standard investigations carried out if you suspect IBS?

Answer 19

FBC
ESR/plasma viscosity
CRP
Antibody testing for coeliac disease TTG
Lower GI testing if FH of CRC

Question 20

What lifestyle changes may be required to treat IBS?

Answer 20

• Regular meal times
• Reduce fibre then gradually increase
• FODMAP/GFD

Question 21

Which drug treatments may be required for IBS?

Answer 21

Anti-diarrhoeals, anti-spasmoidics, anti-depressants, laxatives, psychological treatments

Question 22

Give an example of an anti-diarrhoeal drug used in IBS.

Answer 22

Loperamide

Question 23

Give examples of anti-spasmoidic drugs used in IBS.

Answer 23

Buscopan, Mebeverine, Hyoscine

Question 24

Give an example of an anti-depressant used in IBS.

Answer 24

Amitriptyline

Question 25

What is meant by Opiate/Narcotic bowel syndrome?

Answer 25

Opiates/Narcotics sensitise the nerves, resulting in increased pain