Irritable Bowel Syndrome

Question 1

Irritable Bowel Syndrome Dx

Answer 1

clinical. Pain+diarrhea+-constip.
No weight loss

No blood or white blood cells in the stool.

Question 2

Irritable Bowel Syndrome pain

Answer 2

• Relieved by a bowel movement
  or change in bowel habit such as diarrhea
• Less at night

Question 3

Irritable Bowel Syndrome Tx

Answer 3

1 Fiber in the diet
2 Antispasmodic agents such as:
Hyoscyamine
Dicyclomine
Peppermint oil
3 Tricyclic antidepressants (e.g., amitriptyline or SSRIs)

Question 4

Additional therapy for diarrhea-predominant IBS:

Answer 4

-Rifaximin:
-Alosetron: inhibitor of serotonin with modest effect in IBS; needs special
permissions to use
-Eluxadoline:mu-opioid receptor agonist for diarrhea IBS; relieves
pain/slows bowel

Probiotics: unclear. Do not choose

Question 5

Additional therapy for constipation-predominant IBS:

Answer 5

Fiber
Polyethylene glycol (PEG): nonabsorbed bowel lubricant
Lubiprostone (chloride channel activator): use if PEG doesn’t work
Linaclotide (guanylate cyclase agonist): use if PEG doesn’t work