IBS and functional GI disorders Flashcards Preview

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Flashcards in IBS and functional GI disorders Deck (23):
1

How are functional GI disorders defined?

variable combinations of chronic or recurrent GI symptoms not explained by structural or biochemical abnormalities

2

Describe common clinical presentations of IBD

abdominal discomfort, altered bowel habits that can be diarrhea predominant, constipation predominant, or mixed
abdominal tenderness to palpation- visceral hypersensitivity
abnormal stool passage- rectal dissatisfaction
mucus in stool
bloating

3

What are the criteria for a diagnosis of IBS?

abdominal pain or discomfort at least 3 days/ month for at least 6 months
+ 2 or more of:
improvement with defecation
onset associated with change in frequency of stool
onset associated with change in form of stool

4

List alarm features that warrant a more significant evaluation

rectal bleeding
weight loss
iron deficiency anemia
nocturnal symptoms
family or personal history of colon cancer, IBD, celiac

5

In evaluation of possible IBS, what patients should receive colonoscopy?

over 50 yrs or alarm features

6

Patients with IBS-D or IBS-M should also be screened for:

celiac disease

7

True or false: depression/ anxiety cause IBS

FALSE
but can amplify symptoms when IBS is presetn

8

List inflammatory findings that are abnormal in patients with IBS

- higher lymphocyte count per ganglion
- more inflammation in myenteric plexus
- increased pro-inflammatory cytokines
- abnormal mast cells

9

Many patients with IBS can relate the onset of their symptoms to:

a case of bacterial or viral gastroenteritis

10

What factors increase the likelihood of IBS developing following a GI infection?

female
more severe diarrheal illness
bloody diarrhea during illness
losing > 10 lbs during illness

11

Patients with IBS have increased ________, indicating the role of enteric nervous system pain fibers

visceral hypersensitivity

12

The antidiarrheal agent loperamide is not more effective than placebo at reducing pain, bloating, or global symptoms of IBS, but it is an effective agent for the treatment of ________.

diarrhea

reduces stool frequency, and improving stool consistency.

13

A nonabsorbable antibiotic _________ is more effective than placebo for global improvement of IBS and for bloating

rifaximin

14

What are the down sides to using rifaximin to treat IBS?

expensive
patients may need to take very long term

15

The 5-HT 3 receptor antagonist ______ may be effective at relieving global IBS symptoms in diarrhea.

alosetron

16

Alosetron should NEVER be used to treat ________

constipation

17

______ and _____ may be effective in treating global IBS symptoms and abdominal pain and much lower doses than usual

SSRIs and TCAs

18

Though there is no proven benefit, many patients feel better when using _________ supplements such as psyllium and wheat bran

dietary supplemental fiber

19

_______ drugs can function as anti-spasmodic agents in the gut and reduce pain and bloating

anticholinergics
ex dicylomine, hyocyamine

20

The elective C-2 chloride channel activator lubiprostone is approved for use specifically in:

females with IBS-C

21

What is the role of prokinetics like metoclopramide in IBS?

No proven benefit

22

_____ is a 5-HT 4 receptor agonist that was used to reduce pain and bloating in IBS-C but was taken off the market

tegaserod

23

Increase in _______ has also been shown to have a beneficial effect on IBS symptoms.

physical activity