Irritable Bowel Syndrome (IBS) Flashcards
Are IBS and IBD the same?
NO
How common is IBS?
Very common, ranges from mild-severe
What is the main cause of IBS?
No clear cause
Irritable Bowel Syndrome?
Motility in the gut
What does an individual with IBS experience?
Individuals with IBS detect peristalsis and experience pain even if no food is in the gut
What would you see in the diagnostic tests for a patient with IBS?
There would be no abnormality of structure or biochemistry
What is the etiology of irritable bowel syndrome?
- Unclear
- Linked to lactose intolerance, diet, FODMAP, stress, smoking
Peristalsis?
Motility in the gut
Lactose intolerance?
The gut cannot process lactose, a carbohydrate, so the bacteria process it, producing gas as a byproduct.
Which cells in the gut produce serotonin?
Enterochromaffin cells
What does FODMAP stand for?
Fermentable, Oligosaccharide, Disaccharide, Monosaccharide and Polyols
What are the 3 theories for IBS? (do not explain)
- Motility and sensation
- Serotonin signalling defect at molecular level
- Fermentable, oligosaccharide, disaccharide, monosaccharide and polyols (FODMAPs)
What is motility and sensation regulated by?
The nervous system
Explain the following theory:
- Motility and sensation
Alteration or abnormality in the central nervous system regulation of GI motor and sensory function
Serotonin?
Neurotransmitters that activate neurons in the bowels
Which cells in the gut produce serotonin?
Enterochromaffin cells
What is the 1. primary site of serotonin synthesis?
2. secondary site of serotonin synthesis?
- Gut mucosa
2. nervous system
The serotonin signalling defect affects the functions of serotonin resulting in the manifestations of IBS. Explain the functions/mnfts.
- secretion in the gut, resulting in excess mucous in gut-> mucoid stools
- serotonin involved in perfusion of bowels-> decreased function
- sensation in the gut-> pain
List two examples of Polyols.
- Sorbitol
2. ethanol
What are the manifestations of IBS?
- abdominal discomfort and pain
- diarrhea or constipation (often alterations between both)
- flatulence
- nausea
- mucoid stool
Flatulence?
Gas
Diagnostics for IBS?
- by exclusion (must exclude obvious causes such as infection)
- labs (CBC, CRP, stool ova and parasites test)
- Gastroscopy
- Colonoscopy
- presentation -> if every test is negative, IBS is diagnosed by manifestations
How is mild IBS treated?
No treatment. Pt can cope with symptoms by avoiding offending foods.
How is severe IBS treated?
Drugs for symptomatic management , as well as avoiding offending foods and decreasing emotional stress
