Irritable Bowel Syndrome* Flashcards
What is IBS
Functional Chronic bowel disorder (3 months GI Sx with no cause)
What are the three types of IBS
IBS-C = Constipation IBS-D = Diarrhoea IBS-M = Mixed
What is the Pathology of IBS
Intestinal motility disorder
Increased Visceral Perception
Neuro-gut axis dysfunction
Microbial imbalance
What are the risk factors of IBS
GI infection
History of diarrhoea
Anxiety, stress and depression
Eating disorder
What is the ABCM presentation of IBS
Abdominal pain and tender
Bloating (Defecation relief)
Change in bowel habit
Mucus in rectum/stool
What is the diagnosis criteria for IBS
Rome Criteria
How does the ROME Criteria assess IBS
Once Weekly Abdominal pain for 3 months with 2 of……
- Defecation relief
- Change in stool form
- Change in stool frequency
What are the only investigations done for IBS
TO EXCLUDE OTHER CAUSE
FBC/ESR/CRP = not raised Faecal calcoprotien = not raised Coeliac Serology (IgA and Anti TTG antibodies)
How would manage a mild case of IBS
Change in diet (small frequent meals with more water)
How would you manage IBS-C
Soluble fibre
-Dissolves in water so stools soften
How would you manage IBS-D
Insoluble fibre
-No dissolving in water so stools harden
How would you manage moderate IBS
Pain? Antispasmodics
Constipation? Imodium
Diarrhoea? laxatives
if no improvement try SSRI or trycyclic antidepressants
How would you manage severe IBS
pain treatment center
TCA/SSRI
What are the red flags for Colon cancer
Weight loss Bleeding on defecation -> Anaemia Mass (Abdo/rectal) Raised Inflammatory marker Age>50
