Psychosomatics - Irritable Bowel Syndrome Flashcards
What is psychosomatics?
Psychosomatic disorders are disorders where emotional or psychological factors can impact on the syndrome
Give another term for psychosomatic
pyschophysiological
aligns to the BIO, SOCIAL, PSYCHO model of illness
Give some common examples of psychosomatic disorders
- asthma
- atopic dermatitis
- tension-type headaches
- chronic fatigue syndrome
- irritable bowel syndrome
What are functional gastrointestinal disorders (FGIDs)
functional GI disorders are disorders of gut-brain interaction. It is a group of disorders classified by GI symptoms related to any combination of the following:
- motility disturbance
- visceral hypersensitivty
- altered mucosal and immune function
- altered gut microbiota
- altered CNS processing
summarise the effect of psychosomatic disorders
those in which a persin emotional or psychological state can impact ipon symptoms
Outline irritable bowel syndrome
- common condition that affects the digestive system
- symptoms: stomach cramps, bloating, diarrhoea and constipation
- lifelong problem
- no cure (diet changes can control symptoms)
- cause is unknown
What are the main symptoms of IBS
- stomach cramps - worse after eating, better after doing a poo
- bloating - full and swollen
- diarrhoea - watery and urgency
- constipation - straining and can’t empty bowels
What are the additional symptoms assoicated with IBS?
- farting (flatulence)
- passing mucus from your bottom
- tiredness and a lack of energy
- feeling sick (nausea)
- backache
- problems peeing - needing to pee ofte, urgency and can’t fully empty baldder
- Incontinence
What is the occurence of IBS?
- 20-30 years old
- ~11% of the population
- more common in women
Describe the Rome IV Criteria
- In the last 3 months, with symptoms at lwast 6 months prior to diagnosis the individual experiences recurrent abdominal pain at least 1 day/week in the last 3 months associated with two or more of the following
- related to defecation
- associated with a change in frequency of stool
- associated with a change in form of stool
What is the criteria in the UK to have a diagnosis of IBS?
in addition to the Rome IV criteria
- a change in how you pass stools
- bloating, hardness or tension in the abdomen
- symtpoms worse after eating
- passing mucus from rectum
What exclusion tests are usually carried out before diagnosing IBS?
- blood tests to rule out other conditions (coeliac)
- stool sample to rule out other conditions (calprotectin - IBD)
What areas does IBS mainly impact?
- work
- visits to health professionals
- Health related quality of life
- psychological health
Biological causes of IBS
- abnormal muscle contraction
- Serotonin receptos
- Infection
- Food intolence
Psychological causes of IBS
- psychological disorders e.g. depression and anxiety
- psyciatric disorders (40-60% of patients have FGID)
- hyper-reactivity in the brain-gut interface
What are the social causes of IBS?
- stressful life events
- adverse childhood experiences (sexual, physical and emotional abuse)
- social learning
Draw a diagram of the common sense model of illness
What are the main methods of management of IBS?
- diet/lifestyle changes
- drug treatments
- complementary therapies
- psychological approaches
What are the recommened diet/lifestyle changes for IBS?
- Food diary
- food intolences
- healthy diet
- Assess activity levels
First line drug treatments for IBS
- antidiarrheal (loperamide)
- Laxatives (not lactulose)
- Antispasmodics
Second line drug treatments for IBS
- Antidepressants
- TCAs
- SSRIs
- Laxatives (linaclotide only if previous laxatives have not worked)
What complementary therapies are recommended for IBS?
- Nutraceuticals
- Chinese herbal medicine
- probiotics
- peppermint oil capsules
What complementary therapies are not recommended if u have IBS?
- acupuncture
- reflexology
What are the psychological approaches to treating IBS and when are the implemented
After 12 months
- congitive behaviour therapy
- hypnotherapy
- psychological therapy
What are the main targets of IBS treatment?
- reducing disability
- improving coping
- reducing dependence on health care
