Irritable Bowel Syndrome Flashcards
Define Irritable Bowel Syndrome (IBS)?
A functional bowel disorder defined as recurrent episodes of abdominal pain/discomfort (in the absence of detectable organic pathology) for > 6 months of the previous year, associated with two of the following:
- Altered stool passage
- Abdominal bloating
- Symptoms made worse by eating
- Passage of mucous
What are some of the causes of IBS?
Visceral sensory abnormalities
Gut motility abnormalities
Psychosocial factors (e.g. stress)
Food intolerance (e.g. lactose)
What is the epidemiology of IBS?
Common
10-20% of adults
More common in females (2:1 ratio)
What are the presenting symptoms of IBS?
6+ month history of abdominal pain Altered bowel frequency (> 3 motions per day or < 3 motions per week) Abdominal bloating Change in stool consistency Passage with urgency or straining Tenesmus
What is the character of the abdominal pain in IBS?
Pain if often colicky
It is in the lower abdomen
Relieved by defecation or passing of flatus
What are the red flag symptoms of IBS?
Weight Loss
Anaemia
PR bleeding
Late onset (> 60 yrs)
What do you do if any of the red flag symptoms are present in IBS?
Exclude colonic malignancy
What are the signs of IBS on physical examination?
Usually normal on examination
Sometimes the abdomen may appear distended and be mildly tender on palpation on one or both iliac fossae
What is diagnosis generally made from in IBS?
The history but organic pathology must be excluded
What bloods do we do for IBS?
FBC (anaemia) LFT ESR CRP TFT anti-endomysial/anti-transglutaminase antibodies (coeliac disease)
Why do we do a Stool examination for IBS?
Microscopy and culture for infective cause
Why do we do an US for IBS?
Exclude gallstone disease
Why do we do a Urease breath test for IBS?
To exclude dyspepsia due to H.pylori
When do we do an Endoscopy for IBS?
If other pathologies are suspected
What advice do you give someone with IBS?
Dietary modification
