Irritable Bowel Syndrome Flashcards
(18 cards)
What are the subtypes of IBS
IBS - D (diarrhoea)
IBS - C (constipation
IBS - M (mixed constipation and diarrhoea)
How much of the population are affected by IBS
10-20%
What is the ratio of females to males that are affected
2:1
Describe the common presentation of patients
Abdominal pain
Bloating
Change in bowel habit
What 2 factors contribute to the pathophysiology of IBS
Genes and environment
What is visceral hypersensitivity
the reason for the development of functional gastrointestinal diseases, including functional dyspepsia and irritable bowel syndrome
What is defined as IBS
at least 3 months of continuous or recurrent symtoms of:
abdominal pain / discomfort which is relieved on defecation or is associated with change in frequency or consistency of stool
Two or more of the following on at least a quarter of occasions / days:
More than 3 bowel movements per day or less than 3 bowel movements per week
Altered form of stool
Altered passage of stool
Passage of mucus
Bloating or feeling of abdominal distension
What criteria is used to diagnose IBS
Rome III criteria
What are additional clues to IBS
Nocturia - scared of sleeping for running to the toilet
Stress and diet - caffeine rich
What 4 other illnesses are associated with IBS
Fibromyalgia
Chronic fatigue syndorme
Temperomandibular joint dysfunction
Chronic pelvic pain (in women)
Describe the psychological features of IBS
At least 50% are depressed or anxious
What are alarm features of IBS (8 of them)
Over 50 Short duration of symptoms Woken from sleep by altered bowel habit Rectal bleeding Weight loss Anaemia FH of colorectal cancer Recent antibiotics
Name 5 investigations for IBS
FBC
ESR / plasma viscosity
CRP
antibody testing for coeliac disease (TTG)
Lower GI tests if aged >50 or strong FH of CRC
How do we treat IBS
diet - regular meal times and reduce fibre
Drugs - stop opiate analgesia, antidiarrhoeals, anti-spasmodics, anti-depressants
Why do we want to reduce the fibre in the diet in IBS
It aggravates pain
What are the benefits of anti-diarrhoeals?
Inhibit peristalsis and gut secretions to benefit diarrhoea.
No dependency
Why do we use anti-depressants
Reduce diarrhoea
Reduce afferent signals from the gut
Help restore sleep pattern
Fits with “neuroplasticity” theories
What are 3 different types of psychological treatment
Relaxation therapy
Cognitive Behavioural therapy
Hypnosis
