Irritable Bowel Syndrome Flashcards
Irritable Bowel Syndrome
Common chronic functional disorder
Symptoms may occur for years
More frequent diagnosis in women
Characterized by…
Intermittent abdominal pain or discomfort and stool pattern irregularities
Clinical Manifestations
Abdominal pain Diarrhea or constipation Abdominal distention Excessive flatulence Bloating Heartburn, nausea, vomiting Urgency and frequency Sensation of incomplete evacuation
Psychosocial Factors
Psychologic stressors associated w/ development and exacerbation of IBS Common in pts: -Anxiety, panic disorder -Depression -PTSD -Abuse history
Problems NOT associated with IBS
*HE SPECIFICALLY POINTED OUT THIS SLIDE
Anemia Fever Persistent Diarrhea Rectal Bleeding Severe Constipation Weight Loss
Etiology and Patho
No organic cause known
Pts often report hx of GI infections and food intolerances
*role of food allergies is unclear
*other dietary factors such as fermentable saccharides and polyols may contribute to symptoms
Differential Diagnoses
Malabsorption Dietary factors Infection Colorectal cancer Inflammatory bowel disease Endometriosis Psychologic disorders Gynecologic disorders Peptic ulcer disease Celiac disease
Diagnostic Studies
No specific physical findings
Diagnosis is determined by:
-Symptoms
-Ruling out other conditions
Treatment is directed at
Psychologic factors Dietary factors Medications that: -Regulate output -Reduce pain/discomfort
Psychologic Therapies
Cognitive-behavioral therapy
Stress management techniques
Acupuncture
Hypnosis
Nutritional Therapy
Eliminate gas-producing foods Gradually increase fiber intake or use stool bulking agent Eliminate fructose and sorbitol Yogurt tolerated more than milk products Probiotics are helpful Keep a diary/journal
Drug Therapy
Imodium Atropine/Diphenoxylate Lotronex Amitiza & Linzess Tricyclic Antidepressants
Nonpharmacologic Treatments
Teaching and reassurance
Relaxation
Stress management techniques
Complementary and alternative therapies
