Irritable Bowel Syndrome Flashcards

1
Q

Who is most susceptible to IBS?

A

females

people aged 30-40

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2
Q

What causes IBS?

A

Genes
Visceral hypersensitivity: disturbed GI motility, exaggerated gastro-colic reflex, pain, high amplitude propagating contraction

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3
Q

What are the two components of Visceral hypersensitivity?

A

peripheral sensitisation - inflammatory mediators up regulate sensitivity of nociceptor terminals
central sensitisation - increased sensitivity of spinal neurons

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4
Q

What causes central sensitisation?

A

increased pain radiation to somatic structures e.g. fibromyalgia

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5
Q

What causes peripheral sensitisation?

A

onset after infectious gastroenteritis

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6
Q

What constitutes the Rome 3 criteria for IBS?

A

recurrent abdo pain/discomfort for 3 days per month for 3 months:
and 2 or more of:
improvement with defecation, onset associated with increased stool freq, onset associated with change in stool form

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7
Q

What are the important parts of history for IBS?

A
trigger factors
opiate use (cannabis has a link)
bloating, nocturia
bowel habit
psychosocial factors
underlying fears
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8
Q

What are the alarm features for a patient with suspected IBS?

A
age over 50
short duration of symptoms
woken from sleep by bowel habits
weight loss
rectal bleeding
anaemia
FH of coloerectal cancer
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9
Q

What are the diagnostic investigations for IBS?

A

CRP, FBC, ESR, Antibody testing for coeliac disease (TTG), Lower GI tests if under 50 or strong family history

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10
Q

What is the treatment for IBS?

A

Diet – regular meal times, reduce fibre, FODMAP – basic food, gluten free
Drugs – stop analgesia, anti-diarrhoeals (loperamide, inhibits peristalsis and gut secretions), anti-spasmodics, anti-depressants (tricyclics e.g. amitriptyline – reduces afferent signals from the gut)

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