Irritable Bowel Syndrome

Question 1

what is it

Answer 1

commonest functional GI disorder

chronic presentation

Question 2

what is prevelance

Answer 2

females 2:1 males

Question 3

what is rome III criteria

Answer 3

recurrent abdominal pain for 3 days/month for 3 month and at least 2 of

1) improvement with defecation
2) change in stool frequency
3) change in stool appearance

Question 4

what are causes

Answer 4

unknown but thought to be attributed to visceral hypersensitivity:
diet 
infection
menstruation 
psychological factors 
drugs (opiates eg codeine)

Question 5

what are symptoms

Answer 5

bloating
abdominal pain/discomfort 
increased frequency of toilet visits 
mucus stool 
incomplete emptying

Question 6

what are alarm symptoms that suggest deeper cause

Answer 6

age >50
more recent onset 
woken from sleep
rectal bleeding 
weight loss, anaemia 
family history of CRC

Question 7

how is it diagnosed

Answer 7

FBC
CRP
Antibody test for coeliac disease
Lower GI test if >50

Question 8

how is it treated

Answer 8

improve diet, reduce no of meals 
low FODMAP diet 
stop opiates and analgesia 
anti-spasmodic (mebeverine, dicycloverine)
anti-diarrhoeal (loperamide)
anti-depressant (amitryptilline)

Question 9

what does eating low FODMAP diet involve cutting down on

Answer 9

Fructose: A sugar found in most fruits and vegetables.
Lactose: A sugar found in dairy foods like milk.
Fructans: Very similar to fructose, found in many vegetables and grains
Galactans: Found primarily in legumes.
Polyols: Sugar alcohols like xylitol, sorbitol, maltitoland mannitol. You find them mainly in artificial sweeteners and chewing gum