IBS Flashcards
What is the normal age for IBS onset?
20-39 years old
What are they findings associated with the pathophysiology of IBS?
Altered gastrointestinal motility
Visceral hypersensitivity/hyperalgesia
Altered permeability of the gastrointestinal mucosa
Psychosocial aspects
What are the clinical features of IBS?
Abdominal pain
Frequency, intensity, and localization generally vary widely from patient to patient
Typically related to defecation
Altered bowel habits: diarrhea and/or constipation
Other gastrointestinal symptoms
Nausea, reflux, early satiety
Passing of mucus, abdominal bloating
Extraintestinal symptoms
Generalized somatic symptoms (e.g., pain or fatigue, as in fibromyalgia)
Disturbed sexual function
Dysmenorrhea
Increased urinary frequency and urgency
Physical examination: normal
Associated conditions
Fibromyalgia, chronic fatigue syndrome
Major depression, anxiety, somatization
GERD, functional dyspepsia
Noncardiac chest pain
What are the subtypes and variants of IBS?
Four different patterns are seen in the presentation of irritable bowel syndrome:
IBS-D (diarrhea is the predominant symptom)
IBS-C (constipation is the predominant symptom)
IBS‑M (mixed diarrhea and constipation)
IBS‑A (alternating diarrhea and constipation)
What is the diagnosis for IBS?
Patient history and Rome 4 criteria for IBS - Recurrent abdominal pain on average at least 1 day per week during the previous 3 months that is associated with 2 or more of the following:
Pain related to defecation
Change in stool frequency
Change in stool form or appearance
A family history of inflammatory bowel disease eg coeliac disease
What is the d/d for IBS?
Bacterial or viral gastroenteritis
Hypothyroidism/hyperthyroidism
Coeliac disease
Lactose intolerance
Bacterial overgrowth syndrome
Chrons disease
UC
Colorectal carcinoma
How do you differentiate between IBS, chron disease, UC, and colorectal carcinoma?
(Look at table on amboss for IBS asunder D/D)
What is the treatment for IBS?
Diet changes - plenty of fluids, high fibre foods, avoidance of - gas producing foods eg beans, onions and prunes, fermentable, short chain carbs eg foods with high fructose content like honey, apples, corn syrup, avoid lactose and gluten
Physical activity
Stress management (identify stress factors, relaxation therapy etc)
Psychological therapy (for patients with psychological conditions)
What is the medical therapy for IBS?
For diarrhoea - anti diarrhetics
For constipation - soluble fibres/ bulk forming fibres (psyllium)
For cramping/pain - antispasmodics or tricyclic antidepressants
