Irritable Bowel Syndrome Flashcards

1
Q

What is IBS?

A

Irritable bowel syndrome is a “functional bowel disorder”. This means that there is no identifiable organic disease underlying the symptoms. The symptoms are a result of the abnormal functioning of an otherwise normal bowel.

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2
Q

Symptoms

A
Diarrhoea
•Constipation
•Fluctuating bowel habit
•Abdominal pain
•Bloating
•Worse after eating
•Improved by opening bowels
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3
Q

Criteria for diagnosis

A

Excluding other pathology
Normal FBC, ESR and CRP blood tests
•Faecal calprotectin negative to exclude inflammatory bowel disease
•Negative coeliac disease serology (anti-TTG antibodies)
•Cancer is not suspected or excluded if suspected

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4
Q

Criteria for diagnosis (symptoms)

A

Abdominal pain / discomfort:
•Relieved on opening bowels, or
•Associated with a change in bowel habit

AND 2 of:
•Abnormal stool passage
•Bloating
•Worse symptoms after eating
•PR mucus
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5
Q

Lifestyle

A

Adequate fluid intake
•Regular small meals
•Reduced processed foods
•Limit caffeine and alcohol
•Low “FODMAP” diet (ideally with dietician guidance)
•Trial of probiotic supplements for 4 weeks

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6
Q

1st line medications

A

Loperamide for diarrhoea
•Laxatives for constipation. Avoid lactulose as it can cause bloating. Linaclotide is a specialist laxative for patients with IBS not responding to first line laxatives
•Antispasmodics for cramps e.g. hyoscine butylbromide (Buscopan)

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7
Q

Second line meds

A

Tricyclic antidepressants (i.e. amitriptyline 5-10mg at night)

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8
Q

Third line meds

A

SSRIs antidepressants

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9
Q

therapy

A

Cognitive Behavioural Therapy (CBT) is also an option to help patients psychologically manage the condition and reduce distress associated with symptoms.

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