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Flashcards in IBS Deck (12):
1

IBS is more common in F/M
is characterised by:

Females 2:1
chronic, relapsing abdo pain/discomfort
bloating
change in bowel habit

2

In 2/3rds of patients the pathophysiology of IBS is due to ____
1) ___ sensitisation
2) ___ sensitisation

visceral hypersensitivity
peripheral and central sensitivity

3

20% of peripheral sensitisation in IBS patients is due to

previous infectious gastritis - inflam. mediators upregulate nociceptor terminals in gut

4

central sensitisation in IBS is due to __

increased sensitivity of spinal neurones
causes increase in pain which radiates to somatic structures

5

Rome III criteria for IBS

recurrent abdo pain for more than/= 3 days/month for 3 months
+ more/= 2 of: improvement with defaecation, onset ass with change in stool form/freq

6

If symptoms improve with defaecation think

IBS

7

In a Hx of someone with IBS may see:

fibre worsens symptoms
dietary exclusions
triggers
opiate use

8

Investigations for IBS

FBC
ESR (plasma viscosity)
CRP
TTG Ig (rule out coeliacs)
lower GI test if suspect ca

9

Diet for IBS =

regular meals
low FODMAP then 6-8wks reintroduce restricted foods
low fibre
low tea coffee and sorbitol (if diarrhoea predom)

10

Anti-spasmodics used in IBS

mebeverine
hyoscine

11

anti-depressant that can be used to treat IBS

tricyclics eg. amitryptyline
decreases diarrhoea, afferents from gut, restores sleep pattern
give low dose at night

12

Treatments for IBS

stop opiates
diet
antispasmodics
laxatives (PEG better than lactulose)
anti-diarrhoeals - loperamide
amitryptyline
CBT, hypnosis etc