Irritable Bowel Syndrome Flashcards
what is IBS
recurrent abdominal pain and abnormal bowel motility resulting in constipation or diarrhoea
pathology of IBS
pain - nerve endings in bowel are hypersensitive to stretching
bowel motility - short chain carbs draw water into lumen which can cause smooth muscle spasm
risk factors of IBS
gastroenteritis
stress
treatment of IBS
symptomatic
- diet modification to avoid short-chain carbs
- laxatives and stool softener
- antimuscarinics
- manage stress and anxiety
presentation of IBS
abdominal pain
changed bowel habit
abdominal bloating
incidence of IBS in GP
~4 a year
what usually relieves IBS symptoms
defaecation
NICE diagnositc criteria of IBS
abdominal pain/discomfort relieved by defaecation or associated with changed stool plus 2 of:
- altered stool passage
- abdominal bloating
- passage of mucus
- symptoms made worse by eating
what would you expect to find on examination in IBS
other than the bloating, nothing, hence the functional nature of the disorder
investigations in IBS
mostly of exclusion
FBC CRP IgA Stool culture calprotectin colonoscopy
what is calprotectin
a protein released by inflamed gut mucosa
what diet do you put people on in IBS
FODMAPS diet. it excludes sources of carbs
psychological interventions in IBS
CBT
hypnotherapy
psychodynamic interpersonal therapy
relaxation training
what are the two classifications of IBS
IBS-C and IBS-D
what is different between IBS-C and IBS-D
IBS-Constipation has reduced gut motility
IBS-Diarrhoea has increased gut motility
