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GI- Week 4 & 5 > Irritable Bowel Syndrome > Flashcards

Irritable Bowel Syndrome Flashcards

1
Q

What are the worrying signs of IBS

A
  • In wheelchair due to pain - Given up work due to pain - Needs to carry water all the time to cope
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2
Q

Is IBS a chronic or acute disease?

A

Chronic

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3
Q

Three main symptoms of IBS?

A
  1. Abdominal pain
  2. Abdominal bloating
  3. Atlered bowel habbit- causing constipation or diarrhoea
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4
Q

Genetic and environmental factors play a role in IBS. T/F?

A

True

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5
Q

What is visceral hypersensitivity?

A

Sensory nerve endings in the intestinal wall have an abnormally strong response to stimuli, especially during or after a meal.

Everything from digestion to urination becomes very painful

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6
Q

What is the Rome III criteria?

A
  1. Recurrent abdo pain/discomfort at least 3 days per month for 3 months + 2 or more of- -

Improvement with defecation -

Onset assoc with stool frequency - Onset assoc with stool form

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7
Q

Some other symptoms of IBS?

A
  • Bloating - Urgency - Sensation of incomplete emptying - Mucus per rectum - Nocturia - Stress aggrevation
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8
Q

IBS can be related to what other illnesses? (hint- pain + tired)

A
  1. Fibromyalgia
  2. Chronic fatigue syndrome
  3. TMJ dysfunction
  4. Chronic pelvic pain
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9
Q

IBS is closely related to what psychological disorder?

A

Anxiety/depression- seen in 50% of cases

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10
Q

Important aspects of history in IBS

A
  • Bowel habit- bloating, nocturia
  • Diet: bread, fibre, meal times
  • Trigger factors: infection, menstruation, drugs
  • Opiate use: codeine & opiate bowel syndrome
  • Stress
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11
Q

What are the Alarm features that the problem is not IBS but something else?

A
  1. Age > 50yrs
  2. Short duration of symptoms
  3. Woken from sleep by bowel habit
  4. Rectal bleeding
  5. Weight loss
  6. Anaemia
  7. Family history
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12
Q

What investigations are needed for IBS?

A
  1. FBC
  2. ESR/plasma viscocity
  3. CRP
  4. Antibody testing for Coeliac
  5. Lower GI tests if aged >50 or strong FH of colorectal cancer
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13
Q

What are the two main mainstay’s of treatment?

A
  1. Diet- reduce fibre FODMAP/GFD
  2. Drugs- Stop Opiates, Anti diorrhetics, anti-spasmodics, anti- depressants
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14
Q

What are the first line treatments for IBS relating to the following symptoms:

  1. Pain
  2. Constipation
  3. Diarrhoea
A
  1. Pain- Antispasmodics eg Alverine, Mebeverine
  2. Constipation- Laxatives avoid lactulose eg Bisacodyl
  3. Diarrhoea- Loperamide anti diarrhoeal.
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15
Q

2nd line treatment in IBS? (Hint- depres)

A

Anti-depressants

Tricyclics- eg Amitriptyline: 20mg

Reduce diarrhoea by reducing afferent signals from the gut.

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GI- Week 4 & 5 (15 decks)

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