Flashcards in Irritable bowel Syndrome Deck (12):
1
probable aetiology
due to disorders of intestinal motility or enhanced visceral perception
'brain-gut' axis
2
History of symptoms
chronic, >6 months,
exacerbated by stress, menstruation or gastroenteritis
3
signs
Examination often normal
general abd tenderness
Examination rectal/abd mass
4
Criteria
Pain is either relieved by defecation or associated with altered stool form or bowel frequency (constipation and diarrhea may alternate)
AND ≥2 of: urgency, incomplete evacuation, abd bloating/distension, mucous PR, worsening of symptoms after food.
5
Diagnostic tets
normal bloods
initial: coeliac serology (tTG, IgA Endomesial antibodies)
further: faecal calprotectin, colonoscopy, CA125, TSH
6
DDx
coeliac disease, lactose intolerance, bile acid malab, IBD, colorectal cancer
7
Tx constipation
avoid insoluble fibre
Laxatives e.g. bisacodyl
8
Tx diarrheoa
avoid sorbitol sweeteners
bulking agent + loperamide (an anti motility agent) after each lose stool
9
Tx pain
oral antispasmodics (a.k.a anticholinergics)
e.g. benzatropine
block ACh in the brain
10
Tx psychological symptoms
CBT, hypnosis
11
Name a tricyclic antidepressant and when you'd use it
+ its main SE
amitriptyline
when nothing else works
SE: drowsiness, 4-6 weeks to take effect
NOT for depression
12