IBS

Question 1

What are they key symptoms of IBS?

Answer 1

Pain, bloating,
diarrhoea/constipation
Also often mucus, food triggers, flatulence
Incomplete stool evacuation
Change in bowel habit

Question 2

Length of time need symptoms before diagnosis IBS

Answer 2

6 months

Question 3

What disease to test for with IBS symptoms?

Answer 3

Coeliac
IBD

Question 4

Management of IBS

Answer 4

Dietary advice:
Not too much time between meals
Cut out spicy foods, alcohol, triggers eg tomatos
Low FODMAP diet

Question 5

Likely groups to have IBS

Answer 5

20-30 year old female
Genetic component - runs in family

Question 6

Pathogenesis IBS

Answer 6

Abnormal smooth muscle -> GI function
Hypersensitivity to pain/viscera
Mental health/psychological link - anxiety
Colonic microbiota
Autonomic activity

Question 7

Features of IBS

Answer 7

• Functional
• Chronic,relapsing
• Spectrumal
• Pain/discomfort - generalised and mobile
• Bloating
• 20-30 years
• 15% population, women more then men

Question 8

Associated conditions IBS

Answer 8

Fibromyalgia, FBD, headaches, backaches, affective disorders - mood disorders

Question 9

Treat IBS lifestyle

Answer 9

• Diet/nutrition
• Low FODMAP diet
• Regular meals
• Hydration
• Caffeine
• Alcohol
• Therapy on treating symptoms and how approach them - how process behaviours
• Dynamic/dialectical psychotherapies
• PTSD - approach very carefully, triggering

Question 10

What is loperamide used for inIBS?

Answer 10

Diarrhoea

Question 11

What does mebeverine do?

Answer 11

Antispasmodic
abdo pain and spasms

Question 12

Linaclotide what does

Answer 12

Used whne other laxatives haevnt worked constipation

Question 13

What laxative to acoid in IBS

Answer 13

Lactulose

Question 14

RIsk factors for IBS

Answer 14

Genetic
Enteric infection eg GE
Dietary factors
Drugs - antibiotics
Pscyhcosocial

Question 15

What investigations should be carried out in people with IBS

Answer 15

FBC, ESR, CRP, LFTs
Coeliac disease screening - TTG
CA-125
Fecal calprotectin - IBD

Question 16

Why test for CA-125 in women?

Answer 16

Screen for ovarian cancer

Question 17

If diagnosis unclear what investigations do for IBS

Answer 17

TFTs
US abdo
Colonsocpy
Faecal occult blood test
Faecal ova and parasite tests
H.pylori screen

Question 18

When is a diagnosis of IBS considered time scale?

Answer 18

At least 6 months of
Abdo pain
Bloat
Change in bowel habit

Question 19

When can IBS be considered on initial presentation?

Answer 19

Abdo pain relieved by defecation or ass w bowel frequency or stool form altering, + 2 of 4 form
Altered stool passage - strain, urgency, incomplete
Abdo pain, distension, hardness
Symptoms triggered by eating
Passage of mucus
(lethargy, nausea, back ache, bladder)

Question 20

IBS ass conditions

Answer 20

Fibromyalgia, FBD, headaches, backahes, affective disorders, mood disorders