Irritable Bowel Syndrome Flashcards
Altered regulation of GI ______ and ______ fx
Motor and sensory
What is different about peristalsis in a person with IBS as opposed to someone w/out it
Peristalsis presents with pain in IBS
What are 5 proposed links that contribute to IBS?
- Diet
- Lactose intolerance
- Stress
- Smoking
- FODMAPs
What does FODMAPs stand for?
- Fermentable
- Oligosaccharides (more than 2 combined sugars)
- Disaccharides (2 combined sugars)
- Monosaccharides (simple sugars)
- And
- Polyols (sugar alcohols)
IBS patho theories:
- Malabsorption of polyols and fermentable carbs are processed by gut flora, which results in abdominal discomfort
- Molecular signalling defect for serotonin
What are the Fxs of serotonin in the gut?
- Motility
- Perfusion
- Secretion
- Sensation
How do the Fxs of serotonin in excess contribute to IBS?
- Motility = movement of contents through the gut is abnormal
- Secretion = more mucous will be secreted in the gut, contributes to the mucoid stools
- Sensation = abdm pain
What are the mnfts of IBS?
- Diarrhea (soft, frequent, mucoid stools, not watery) and
constipation (may alternate between those two
consistencies) - Abdm pain/discomfort
- Flatulence
What are the Dx for IBS?
- Exclude organic disease (eg IBD)
- Labs (look for parasites, all the normal labs, blah blah)
- Gastroscopy, colonoscopy
What will a gastroscopy or colonoscopy find in a person with IBS?
Nothing if its IBS
What is he Tx for IBS?
- Avoid FODMAPs
- Dec stress
- Drugs PRN:
- Antispasmotics (eg Modulon)
- Antidiarrheals
- Laxatives
- Abx
Why do we need to be careful about Tx of IBS with Abx
Because these will dec normal gut flora as well as any pathogens
What does “microbial antagonism” refer to?
This refers to the fact that microbes all compete for the nutrients of the space they occupy. More normal flora = less space and nutrients for pathogens, and vice versa
