Irritable Bowel Syndrome

Question 1

What is IBS

Answer 1

• lower abdominal spasms
• bloating
• altering constipation and diarrhoea
• aggravated by stress, depression an anxiety and lack of dietary fibre
  (common to young adult women)

Question 2

Referral for IBS part 1

Answer 2

• children
• over 45 first time symptom (can be cancer)
• blood in stools
• bowel obstruction (abdominal bloating, colic)

Question 3

Referral for IBS part 2

Answer 3

• unexplained weight loss, appetite loss
• fever and nausea snd vomiting
• pregnant
• suspected depression

Question 4

OTC treatment: Antispasmodics

Answer 4

• Mebeverine (18+)
  Colofac IBS
• Alverine (12+)
  Spasmonal
• Peppermint Oil (15+)
  Colpermin IBS Relief

Question 5

How do antispasmodics work

Answer 5

relaxes smooth muscle to reduce abdominal spasms

Question 6

How to take peppermint oil

Answer 6

swallow capsule whole

• can irritate mouth and oesophagus
• common side effects include: heart burn

Question 7

OTC treatment: Antimuscarinics

Answer 7

Hyoscine (12+)
- Buscopan

Dicyloverine (12+)
- Kolanticon gel

Question 8

How do antimuscarinics work

Answer 8

Anticholinergic effect relaxes gut smooth muscle

Question 9

What medication interacts with Antimuscarinics increases anticholinergic effect

Answer 9

• Anthistamines
• TCA’a
• Antipsychotics

Question 10

When to avoid Antimuscarinics

Answer 10

• in glaucoma
• in prostatic enlargement

Question 11

What other symptoms do we treat with OTC

Answer 11

• Constipation
• Diarrhoea

Question 12

Advice for IBS

Answer 12

• limit to 3 portions o fruit and veg
• increase soluble fibre intake (oats)
• avoid insoluble fibres (whole grain, veg)
• eat regularly and dont avoid meals
• drink a lot of water a day (8 at least)
• limit stress
• take probiotics