Irritable Bowel Syndrome

Question 1

Risk factors + triggers

Answer 1

RFs - Genetic, Environmental, Psychosocial

Triggers - surgery, diverticulitis, chronic stress, food intolerances

Question 2

Symptoms

Answer 2

Nausea
Lethargy
Backache
Bladder symptoms

Question 3

Classification

Answer 3

Subtypes - IBS C/D/M/U

Rome IV - recurrent abdo pain in last 3m

Question 4

Diagnosis

Answer 4

V invasive
Get good diet history
Exclude coeliac disease
CRP
Full blood count

Question 5

Treatment

Answer 5

1. Diet + lifestyle
2. Low FODMAPS
   Drugs - laxatives, anti-spasmodics, Loperamide

Question 6

Diet + lifestyle advice

Answer 6

First line treatment
Given by any healthcare professional

Healthy eating, increase PA, regular meals, take time, chew, relax

Question 7

Low FODMAPS

Answer 7

6-8wk of strict diet then challenge at 8-12wk
Functional symptom evaluation to assess efficacy

Short chain CHO fermented by bacteria in large intestine
=> wind, bloating

Question 8

Low FODMAPS

Suitability

Answer 8

Motivated
Cooking skills
Knowledge
Finances

Question 9

Low FODMAPS

Barriers

Answer 9

Slow improvement
Eating out
Family

Question 10

Low FODMAPS

Reintroduce

Answer 10

Identify triggers
Stop unnecessary restrictions

Watch out for timing (e.g. holidays)

Question 11

Low FODMAPS

Consider

Answer 11

Ca + energy decrease

Gut microbiota decrease