Treatment of IBS

Question 1

What is IBS characterised by?

Answer 1

bouts of diarrhoea
constipation
abdominal pain

Question 2

First line pharmacological treatment of IBS

Answer 2

antispasmodic agents
laxative for constipation
loperamide

Question 3

First choice anti-motility agent for diarrhoea?

Answer 3

loperamide

Question 4

Antispasmodics examples

Answer 4

Hyoscine butylbromide
Atropine sulfate
Dicycloverine hydrochloride

Question 5

Mechanism of action of antispasmodics

Answer 5

competitively antagonise action of ACh in the enteric plexus

relieve muscle contractions

Question 6

Adverse effects of antispasmodics

Answer 6

dry mouth
blurred vision
cardiac arrhythmias

Question 7

Function of peppermint oil and mebeverine

Answer 7

direct relaxation of smooth muscle in the GI wall

Question 8

Second line pharmacological treatment of IBS

Answer 8

linaclotide
low-dose TCA
low-dose SSRI

Question 9

When can second-line pharmacological treatment be offered?

Answer 9

when no response to laxatives with constipation for over 1 year