Flashcards in Irritable Bowel Syndrome Deck (20):
What is IBS?
Irritable bowel syndrome - Chronic relapsing problem of abdominal pain and bloating. Includes a change in bowel habits
What are the Pathophysiological signs of IBD?
Disrupted GI motility
High-amplitude propagating contractions
exaggerated gastro-colic reflexes
What are the two types of visceral hypersensitivity?
peripheral sensitisation or central sensitisation
What causes peripheral sensitisation?
Inflammatory mediators up-regulate the sensitivity of nociceptor terminals
what causes central sensitisation?
increased sensitivity of spinal neurones
what criteria is used to diagnose IBS?
Rome III Criteria
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
What other symptoms suggest IBS? (6)
Urgency to defecate
Sensation of incomplete emptying
Nocturia and poor sleep
Aggravated by stress
What other illnesses is IBS associated with? (4)
Chronic fatigue syndrome
Chronic pelvic pain
What are the important points to learn in a history for people with IBS?
What are the alarm features for IBS?
Short duration of symptoms
Woken up by altered bowel habits
Family history of colorectal cancer
Recent antibiotic treatment
What investigations would be performed?
FBC - check for ESR and CRP
Antibody testing for coeliac disease - TTG
Lower GI tests if older than 50
What should be altered in a patients diet as a form of treatment?
Reduce fibre intake
Introduce regular meal times
Restrict coffee intake
Consider single food avoidance syndrome
Why are opiates stopped?
prolonged use can cause opiate or narcotic bowel syndrome
What is opiate bowel syndrome?
worsening pain control despite escalating dose
Reliance on opiates
Intensity of pain
No GI explanation for pain
what does fibre do to a patient with IBS?
what do anti-diarrhoeals do?
inhibits peristalsis and gut secretion
Has no effect on pain
what do anti-depressants do?
reduce afferent signals from gut
helps restore sleep pattern
when is psychological treatment used?
If the patient is experiencing severe anxiety or depression and has had no response to anti-depressants