Irritable bowel syndrome

Question 1

Age and gender seen in IBS

Answer 1

Young female

Question 2

General symptoms of IBS

Answer 2

• diarrhoea/constipation (fluctuating)
• abdo pain
• bloating

Question 3

When is IBS pain worse

Answer 3

After eating

Question 4

When does pain in IBS improve

Answer 4

Opening bowels

Question 5

Pathologies that must be excluded before diagnosing IBS

Answer 5

• IBD (-ve faecal calprotectin)
• -ve coeliac serology
• cancer

Question 6

IBS characteristic pain plus 2 other of the following must be present to diagnose IBS

Answer 6

• abnormal stool passage
• bloating
• PR mucus

Question 7

What substance are people advised to avoid in IBS and what are they advised to try for 4 weeks

Answer 7

• FODMAP

- probiotic supplements

Question 8

1st line medication for diarrhoea

Answer 8

Loperamide

Question 9

1st line medication for constipation

Answer 9

Laxatives

Question 10

Which specialist drug to use if laxatives not responding

Answer 10

Linaclotide

Question 11

Why should you avoid lactulose

Answer 11

Bleeding

Question 12

1st line medication for cramps

Answer 12

Antispasmodics (hyoscine butylbromide)

Question 13

2nd line medication that is also a tricyclic antidepressant

Answer 13

Amitriptyline

Question 14

3rd line medication

Answer 14

SSRIs

Question 15

4th line medication

Answer 15

Cognitive behavioural therapy (CBT)