IBS

Question 1

what is the cause in IBS

Answer 1

no organic cause can be found

Question 2

when to diagnose IBS

Answer 2

abdominal pain relieved by defacation or associated with altered stool form or bowel frequency and 2 or more of: urgency, incomplete evacuation, abdo bloating/distension, mucous PR, worsening symptoms after food

Question 3

other symptoms

Answer 3

nausea, bladder symptoms, backache

Question 4

what are the symptoms

Answer 4

chronic, exacerbated by stress menstruation gastroenteritis.

Question 5

signs

Answer 5

abdo tenderness general.

Question 6

when should you do a colonoscopy to rule out other causes

Answer 6

> 50 years, or any marker for organic disease- temperature, blood PR, weight loss

Question 7

what should you test if the diarrhoea is prominent

Answer 7

LFT, stool culture, b12/folate, anti endomysial antibodies (coeliac), TSH, rectal biopsy

Question 8

when should you do an upper GI endoscopy

Answer 8

dyspepsia, reflux

Question 9

small bowel radiology

Answer 9

crohns

Question 10

duodenal biopsy

Answer 10

coeliac eg if anti endomysial antibiodies positive

Question 11

giardia tests

Answer 11

giardia often triggers IBS

Question 12

ERCP or MRCP

Answer 12

if active pancreatitis

Question 13

management- diet

Answer 13

healthy diet. fibre, lactose, fructose, wheat, starch, caffeine, alcohol, fizzy drinks may make worse

Question 14

treat constipation

Answer 14

avoid insoluble fibre. bisacodyl or sodium picosulfate. ispaghula, lactulose

Question 15

treat diarrhoea

Answer 15

avoid sorbitol sweeteners, try bulking agent plus loperamide

Question 16

treat colic/bloating

Answer 16

oral antispasmodics- mebeverine, alverine citrate, dicycloverine