Irritable Bowel Syndrome (IBS)

Question 1

What is IBS.

Answer 1

IBS denotes a mixed group of abdominal symptoms for which no organic cause can be found.
ie: GI symptoms in the absence of structural pathology; abnormal autonomic reactivity or visceral hypersensitivity.

Question 2

What can trigger IBS. (6)

Answer 2

Gastroenteritis (post-infective). 
Stress. 
Menstruation. 
Psychological problems. 
Anxiety. 
Depression.

Question 3

When should a diagnosis of IBS be made. (8)

Answer 3

Abdominal discomfort. 
Relief with defaecation. 
Alternating bowel habit (altered stool form or bowel frequency). 
And two or more of:
Abdominal bloating/distention. 
Urgency. 
Incomplete evacuation. 
Mucous PR. 
Worsening of symptoms after food.

Question 4

Should further tests be ordered in a long typical IBS history in a patient under 45. (2)

Answer 4

No.

Just routine blood tests should be ordered.

Question 5

When should further tests be ordered in a patient presenting with IBS. (3)

Answer 5

>

45. Atypical history.
    Short history of symptoms.

Question 6

What is the prevalence of IBS.

Answer 6

10-20%.

Question 7

What is the typical age of presentation of IBS.

Question 8

What is the female:male ratio of IBS.

Answer 8

2:1.

Question 9

What are some associated symptoms with IBS. (3)

Answer 9

Nausea.
Bladder symptoms.
Backache.

Question 10

What are the signs of IBS. (3)

Answer 10

Physical examination is often normal, but general abdominal tenderness is common.
Insufflation of air during sigmoidoscopy may reproduce the pain.

Question 11

When should you consider other potential diagnosis in a patient who may have IBS. (10)

Answer 11

> 40 years.
Male.
History

Question 12

What must always be investigated further.

Answer 12

PR bleeding.

Question 13

What is the pain often described as in IBS.

Answer 13

Colicky/cramping.