Irritable Bowel Syndorme Flashcards
What is IBS?
A mixed group of abdominal symptoms with no organic cause
What is the likely aetiology of IBS?
- Altered motility
- Visceral hypersensitivity
- Stress, Anxiety, Depression
- Microbial dysbiosis
What is the age of onset of IBS?
<40yrs
What is the diagnostic criteria of IBS?
Recurrent abdominal pain/discomfort associated with at least 2 of:
- Relief by defecation
- Altered stool form
- Altered bowel frequency (constipation/diarrhoea)
What are other clinical features of IBS?
Urgency
Incomplete evacuation
Abdominal bloating/distention
Mucus PR
Worsening of symptoms after food
Belching wind and flatus
What are the features of the abdominal pain experienced in IBS?
- Variable
- Vague
- Bloating
- Burning
- Sharp
- Occasionally radiates to lower back
- Often altered by bowel action
- Rare at night
What is IBS-C?
IBS with constipation
What is IBS-D?
IBS with diarrhoea
What is IBS-M?
IBS with both constipation and diarrhoea (mixed)
What are the investigations for IBS?
Bloods: FBC, U&E, LFT, CRP, TRTs, Ca
Stool culture
Calprotectin
FIT testing
Rectal examination
Colonoscopy
What is the treatment for IBS?
Focus on controlling symptoms, initially using lifestyle/dietary measures then cognitive or pharmacotherapy.
What is the treatment for constipation?
Adequate water and fibre intake
Physical activity
Simple laxatives
Linaclotide
What is the treatment for diarrhoea?
Reduce fibre intake
Identify trigger foods
Bulking agent
FODMAP
What is the treatment for bloating?
Probiotics
Oral antispamodics
What is the treatment for psychological symptoms/visceral hypersensitivity?
Cognitive behavioural therapy
Hypnotherapy
Tricyclics
