Irritable Bowel Syndrome

Question 1

Epidemiology of IBS

Answer 1

IBS tends to begin in adolescence and the 20s,

women are 2-3 times more likely

Question 2

Aetiology of IBS

Answer 2

Historically, the disorder was often considered as purely psychosomatic.

Although psychosocial factors are involved, IBS is better understood as a combination of psychosocial and physiologic factors.

some experience onset after enteric infection

Question 3

Pathogensis

Answer 3

visceral hyperalgesia refers to hypersensitivity to normal amounts of intraluminal distention and heightened perception of pain in the presence of normal quantities of intestinal gas; it may result from remodeling of neural pathways in the brain-gut axis.

Altered GI motility

Question 4

Natural History

Answer 4

chronic relapsing disorder

Question 5

Clincial Manefestations

Answer 5

Irritable bowel syndrome (IBS) is characterized by recurrent abdominal discomfort or pain that is accompanied by at least two of the following:

relief by defecation, change in frequency of stool, or change in consistency of stool.

Symptoms are often triggered by food, particularly fats, or by stress

Question 6

Symptoms

Answer 6

Although bowel patterns are relatively consistent in most patients, it is not unusual for patients to alternate between constipation and diarrhea.

Patients may also have symptoms of abnormal stool passage (straining, urgency, or feeling of incomplete evacuation), pass mucus, or complain of bloating or abdominal distention.

Many patients also have symptoms of dyspepsia. Extra-intestinal symptoms (eg, fatigue, fibromyalgia, sleep disturbances, chronic headaches) are common.

Question 7

Complications

Answer 7

risk of ectopic pregnancy / miscarriage (why)?

Question 8

Prognosis

Answer 8

lifestyle modifications secondary to altered bowel habits.

Work absenteeism resulting in lost wages is more frequent in patients with irritable bowel syndrome.