Flashcards in Irritable Bowel Syndrome Deck (18):
1
What are the subtypes of IBS
IBS - D (diarrhoea)
IBS - C (constipation
IBS - M (mixed constipation and diarrhoea)
2
How much of the population are affected by IBS
10-20%
3
What is the ratio of females to males that are affected
2:1
4
Describe the common presentation of patients
Abdominal pain
Bloating
Change in bowel habit
5
What 2 factors contribute to the pathophysiology of IBS
Genes and environment
6
What is visceral hypersensitivity
the reason for the development of functional gastrointestinal diseases, including functional dyspepsia and irritable bowel syndrome
7
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
8
What criteria is used to diagnose IBS
Rome III criteria
9
What are additional clues to IBS
Nocturia - scared of sleeping for running to the toilet
Stress and diet - caffeine rich
10
What 4 other illnesses are associated with IBS
Fibromyalgia
Chronic fatigue syndorme
Temperomandibular joint dysfunction
Chronic pelvic pain (in women)
11
Describe the psychological features of IBS
At least 50% are depressed or anxious
12
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
13
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
14
How do we treat IBS
diet - regular meal times and reduce fibre
Drugs - stop opiate analgesia, antidiarrhoeals, anti-spasmodics, anti-depressants
15
Why do we want to reduce the fibre in the diet in IBS
It aggravates pain
16
What are the benefits of anti-diarrhoeals?
Inhibit peristalsis and gut secretions to benefit diarrhoea.
No dependency
17
Why do we use anti-depressants
Reduce diarrhoea
Reduce afferent signals from the gut
Help restore sleep pattern
Fits with "neuroplasticity" theories
18