irritable bowel syndrome Flashcards
What is irritable bowel syndrome (IBS)
it is a bowel disorder associated with constipation or changes in bowel habits without abnormal structural changes.
IBS Epidemiology
10-20%
age at onset <40yrs
2F:1M
classis symptoms of irritable bowel syndrome
Recurrent colicky pain in the lower abdomen that is relieved by defecating.
Bloating worsens through the day - ask about diurnal variation
Alternating diarrhoea and constipation
Other symptoms:
Urgency
Incomplete emptying
abdominal bloating/distension
mucous PR
symptoms worsen after food
a nervous 31 year old patient presents with history of chronic diarrhea alternating with constipation.
Often feels bloated. Investigations are normal.
IBS
A 21 year old presents with a cramping diffuse abdominal pain associated with altering constipation and diarrhea. Investigations are normal.
IBS
A is refered to you with pelvic pain. Vaginal examination reveals no abnormalities and pelvic ultrasound scan is normal. She complains of stress at work and finds that emptying her bowels reveals her symptoms
IBS
Signs of IBS
Mucus in stools
no weight changes
Maybe bloating and tenderness on palpation
Investigations in IBS
Usually normal. It is a diagnosis of exclusion.
Mostly feacal calprotectin and sigmoidoscopy.
Management of IBS
Reassure patients that it is not cancer if that is what they are worried about.
Diagnosis of IBS
only diagnose if symptoms are relieved after defecation. Or associated with altered stool or bowel frequency (constipation, and diarrhea)
Cuases of IBS
most are probably caused by disorders of intestinal motility or brain axis
What are the diagnosis critereria for IBS
Manning
Rome II/III
Medicine treatment of IBS
Low dose amitriptyline sometimes works
