Irritable bowel syndrome Flashcards
What are the characteristics of irritable bowel syndrome
Functional GI disorder characterised by: -Abdominal pain/discomfort relieved by defecation -Change in bowel habit (constipation, diarrhoea, both) -Abdominal bloating*
Describe the epidemiology of irritable bowel syndrome
Up to 1/5 of the UK Commoner in young adults M < F (1:2)
Name 3 non-GI symptoms of irritable bowel syndrome
Gynaecological: dysmenorrhoea, dyspareunia (pain after sex) Urinary: frequency, urgency, nocturia, incomplete emptying Other: joint hyper mobility, back pain, headaches, halitosis, poor sleep, fatigue
What comorbidites are commonly seen alongside IBS?
Depression and anxiety Chronic fatigue syndrome Fibromyalgia Temporomandibular joint dysfunction
List 3 factors that trigger onset of IBS
Mood disorders Psychological stress and trauma GI infection ABX Abuse: sexual, physical, verbal Pelvic surgery Eating disorders
Outline the diagnostic criteria for irritable bowel syndrome
Rome IV criteria: Recurrent abdominal pain, at least 1 day/week in the last 3 months, associated with 2 or more of the following: -Related (relieved) to defecation -Associated with change in frequency of stool -Associated with change in form of stool Onset of symptoms at least 6 months prior to diagnosis
What specific symptom would exclude IBS as a differential diagnosis?
Blood in stools or nocturnal defecation ➔ consider IBD
What investigations should be carried out to rule out other differential diagnosis besides IBS?
FBC ESR and CRP Coeliac screen CA125 ➔ ovarian cancer Faecal calprotectin ➔ IBD
Outline the management of Irritable bowel syndrome
Reassurance* Dietary changes Low FODMAPS diet Bulk-forming laxatives (ispagula) for constipation - avoid lactulose as it causes flatulence Antimotility (loperamide) for diarrhoea Antispasmodics (mebeverine) for cramps Peppermint oil for bloating
