Irritable bowel syndrome (IBS)

Question 1

Whats is IBS

Answer 1

Functional Gi motility disorder with no underlying cause

Chronic/relapsing/lifelong
Dx - GI-Sx >3months

types include
IBS-C - consitpation
IBS-D - diarrhea
IBS-M - mixed

Question 2

Epidemiology of IBS

Answer 2

<40 yrs old
female>males

Question 3

IBS triggers/RF

Answer 3

GI infections
Anxiety and depression
Eating disorders
Previous severe long term diarrhoea

Question 4

IBS symptoms

Answer 4

ABC

A - Abdo pain
(relieved by shitting and worsens with eating)

B - Bloating, distension

C - Change in bowel habit
(frequency, straining, urgency) /stool appearance (hard)

Question 5

IBS - DX

Answer 5

It is a functional disorder with unknown origin. so must exclude other DDx:

IBD- Faecal calprotectin
Coeliac -anti-tTg
colorectal cancer - colonscopy
Lactose intolerant

Question 6

IBS - Tx

Answer 6

Dietary advice:
Restrict caffeine
Small and frequent meals
if IBS-C - less soluble fibre
if IBS-D- More soluble fibre

IBS-C - Senna (Laxative)
IBS-D - Lopermide (anti-motility)

2nd line medication:
Tricyclic antidepressants (amitriptyline)