GI 8 treatments

Question 1

Describe management for IBS

Answer 1

1) Clinician-patient relationship key to successful management
2) Direct therapy to the initial predominant symptom
3) Allow adequate time for visits
4) Schedule regular return visits
5) Provide patient with information, educational material
6) Be an empathic listener
7) Reassure patient this is a benign disorder
8) Refer for therapy when necessary

Question 2

1) Name the first line Tx for IBS-C
2) What abt IBS-D?
3) What should you give if they’re mainly complaining of cramping?

Answer 2

1) Linzess
2) Biberci
3) Diacylamine

Question 3

Describe the initial management of colorectal obstruction

Answer 3

1) Supportive care, decompression of sigmoid volvulus
2) Surgical management: Urgent for acute complete or near complete (benign or malignant etiology)

Question 4

Describe the workup of colorectal obstruction

Answer 4

1) CBC with diff, CMP, lipase, UA
2) Acute abdominal series
3) If no clear cause, consider CT
4) NPO
5) Pain Control
6) Medical or Surgical Management

Question 5

Describe the Tx of toxic megacolon

Answer 5

Main goal: reduce severity of colitis (restore normal colonic motility) & decrease likelihood of perforation
1) Supportive & medical therapy prevents surgery ~50%
2) Surgical consultation upon admission to ICU
3) CBC & serial plain abd films q12h, bowel rest (NPO), consider NG tube
4) Discontinue antimotility agents, opiates, anticholinergics
5) Enteral feeding upon improvement
6) Treat underlying conditions: IBD, C. diff colitis