Irritable Bowel Syndrome Flashcards
What is IBS?
A mixed group of abdominal symptoms for which no organic cause can be found
What are likely causes of IBS?
Disorders of intestinal motility, enhanced visceral perception, microbial dysbiosis, disfunction of brain-gut axis
What are the key presentations?
Abdominal pain/discomfort - relieved by defecation
Bloating
Change in bowel habit - stool form/frequency
What are some other features of IBS?
Urgency, incomplete evacuation, abdominal bloating/distension, mucus in stool, worsening of symptoms after food
What can exacerbate symptoms?
Stress, menstruation, gastroenteritis, food
What are potential differential diagnoses?
Coeliac disease, lactose intolerance, bile acid malabsorption, IBD, colorectal cancer, GI infection, pancreatic insufficiency
What general management would you do?
Lifestyle and diet changes
How would you manage IBS-C?
Soluble fibre as it softens stools, barley/oats/beans/prunes/figs, laxatives like macrogol/docusate/senna
How would you manage IBS-D?
Avoid insoluble fibre, loperamide (imodium)
How would you manage colic/bloating?
Antispasmodics like mebeverine or buscopan
What are risk factors for IBS?
GI infections, previous severe long-term diarrhoea, anxiety and depression, psychological stress/trauma/abuse, eating disorders
What are the three types of IBS?
IBS-C, IBS-D, IBS-M
What foods should you avoid?
FODMAP
What drugs can you add if other management fails?
Tricyclic antidepressants
What is an alternative to tricyclic antidepressants?
SSRIs
