Flashcards in IBS and functional GI disorders Deck (23):
How are functional GI disorders defined?
variable combinations of chronic or recurrent GI symptoms not explained by structural or biochemical abnormalities
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
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
List alarm features that warrant a more significant evaluation
iron deficiency anemia
family or personal history of colon cancer, IBD, celiac
In evaluation of possible IBS, what patients should receive colonoscopy?
over 50 yrs or alarm features
Patients with IBS-D or IBS-M should also be screened for:
True or false: depression/ anxiety cause IBS
but can amplify symptoms when IBS is presetn
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
Many patients with IBS can relate the onset of their symptoms to:
a case of bacterial or viral gastroenteritis
What factors increase the likelihood of IBS developing following a GI infection?
more severe diarrheal illness
bloody diarrhea during illness
losing > 10 lbs during illness
Patients with IBS have increased ________, indicating the role of enteric nervous system pain fibers
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 ________.
reduces stool frequency, and improving stool consistency.
A nonabsorbable antibiotic _________ is more effective than placebo for global improvement of IBS and for bloating
What are the down sides to using rifaximin to treat IBS?
patients may need to take very long term
The 5-HT 3 receptor antagonist ______ may be effective at relieving global IBS symptoms in diarrhea.
Alosetron should NEVER be used to treat ________
______ and _____ may be effective in treating global IBS symptoms and abdominal pain and much lower doses than usual
SSRIs and TCAs
Though there is no proven benefit, many patients feel better when using _________ supplements such as psyllium and wheat bran
dietary supplemental fiber
_______ drugs can function as anti-spasmodic agents in the gut and reduce pain and bloating
ex dicylomine, hyocyamine
The elective C-2 chloride channel activator lubiprostone is approved for use specifically in:
females with IBS-C
What is the role of prokinetics like metoclopramide in IBS?
No proven benefit
_____ is a 5-HT 4 receptor agonist that was used to reduce pain and bloating in IBS-C but was taken off the market