L24- GI Drugs II (irritable bowel syndrome)

Question 1

Irritable Bowel Syndrome:

• (1) definition
• (2) classification
• treatment is based on (3)

Answer 1

1- chronic abdominal pain associated with altered bowel habits (constipation, diarrhea) in absence of organic GI disease

2- diarrhea, constipation

3- Sxs / subtype

Question 2

describe first-line treatment for irritable bowel syndrome

Answer 2

(keep food diary)
1) exclude gas producing foods

2) low fermentable oligo-/di-/mono-saccharids and polyols (FODMAPs)
3) lactose +/- gluten free diet

Question 3

_____ is the treatment for constipation dominant IBS

Answer 3

lubiprostone: Cl channel activator laxative

Question 4

list the agents used for treatment of diarrhea dominant IBS

Answer 4

• opioid agonists: loperamide
• 5-HT3 antagonist: alostetron (reduces sensations of bloating, nausea, pain)
• Anti-cholinergics – hyoscyamine, dicyclomine, glycopyrrolate, methscopolamine

Question 5

______ anti-diarrheal agents’ uses are limited in IBS therapy due to many unpleasant side-effects

Answer 5

Anti-cholinergics (=> cholinergic blockade)

-limited to short-term relief in acute diarrhea predominant episodes