Irritable Bowel Syndrome Flashcards Preview

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Flashcards in Irritable Bowel Syndrome Deck (20):
1

What is IBS?

Irritable bowel syndrome - Chronic relapsing problem of abdominal pain and bloating. Includes a change in bowel habits

2

What are the Pathophysiological signs of IBD?

Disrupted GI motility
High-amplitude propagating contractions
exaggerated gastro-colic reflexes
pain

3

What are the two types of visceral hypersensitivity?

peripheral sensitisation or central sensitisation

4

What causes peripheral sensitisation?

Inflammatory mediators up-regulate the sensitivity of nociceptor terminals

5

what causes central sensitisation?

increased sensitivity of spinal neurones

6

what criteria is used to diagnose IBS?

Rome III Criteria

7

IBS is defined as recurrent abdo pain for at least three days per month for 3 months + 2 or more of what?

Improvement with deification
onset associated with change in stool frequency
onset associated with a change in stool appearance

8

What other symptoms suggest IBS? (6)

Bloating
Urgency to defecate
Sensation of incomplete emptying
Mucus PR
Nocturia and poor sleep
Aggravated by stress

9

What other illnesses is IBS associated with? (4)

Fibromyalgia
Chronic fatigue syndrome
TMJ dysfunction
Chronic pelvic pain

10

What are the important points to learn in a history for people with IBS?

Bowel habits
Diet
Opiate use
Psychosocial factors

11

What are the alarm features for IBS?

Short duration of symptoms
Woken up by altered bowel habits
Rectal bleeding
Weight loss
Anaemia
Family history of colorectal cancer
Recent antibiotic treatment

12

What investigations would be performed?

FBC - check for ESR and CRP
Antibody testing for coeliac disease - TTG
Lower GI tests if older than 50

13

What should be altered in a patients diet as a form of treatment?

Reduce fibre intake
Introduce regular meal times
Restrict coffee intake
Avoid sorbitol
Consider single food avoidance syndrome

14

Why are opiates stopped?

prolonged use can cause opiate or narcotic bowel syndrome

15

What is opiate bowel syndrome?

worsening pain control despite escalating dose
Reliance on opiates
Intensity of pain
No GI explanation for pain

16

what does fibre do to a patient with IBS?

aggravates pain

17

what do anti-diarrhoeals do?

inhibits peristalsis and gut secretion
Has no effect on pain

18

what do anti-depressants do?

reduce diarrhoea
reduce afferent signals from gut
helps restore sleep pattern

19

when is psychological treatment used?

If the patient is experiencing severe anxiety or depression and has had no response to anti-depressants

20

what kind of psychological treatments are available?

relaxation therapy
cognitive behavioural therapy
Hypnosis