irritable bowel syndrome

Question 1

most appropriate step when you think something’s irritable bowel syndrome

Answer 1

CBC, stool hemocult test for initial screening

Question 2

Rome diagnostic criteria for irritable bowel syndrome

Answer 2

recurrent abd pain at least 3 days/month for past 3 months, assoc with two or more of following

• improvement w defecation
• onset with change in freq of stool
• onset w change in form of stool

Question 3

tx for IBS-abd pain

Answer 3

antispasmodics (dicyclomine, hyoscyamine)

low dose TCAs (when freq, severe)

SSRIs (comorbid depression, anxiety)

rifaximin (antibiotic for traveler’s diarrhea)

probiotics, peppermint oil

Question 4

tx for IBS-constipation predominant

Answer 4

fiber intake

lubiprostone

Question 5

tx for IBS-diarrhea predominant

Answer 5

loperamide

alosetron (5HT3 antagonist)

Question 6

first line tx for mild to moderate abdo pain assoc with IBS?

Answer 6

dicyclomine (antispasmodic)

Question 7

first line tx for constipation predominant IBS

Answer 7

fiber supplementation (psyllium)