Irritable Bowel Syndrome Flashcards Preview

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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

What are 3 different types of psychological treatment

Relaxation therapy
Cognitive Behavioural therapy
Hypnosis

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