Week 7 IBS + Functional Dyspepsia Flashcards
What is the main presentation of IBS?
Combination of diarrhoea and constipation (or just one)
On/Off pattern
Bloating and abdominal pain
Diurnal pattern
Pathophysiology of IBS
Gut/brain axis dysfunction
Gut microbiotica disturbance
Treatment of IBS
1st line:
Lifestyle advice and dietry advice
2nd line:
Drugs
Low FODMAP diet
Psychological therepies
What are the Rome criteria for IBS diagnosis?
Abdominal pain
AND
2 of:
* Related to defaecation
* Change in stool frequency
* Change in stool form
Symptoms have been present for >6months
Symptoms present on average at least 1day/week for last 3 months
What are the drug therepies for IBS?
Low does Amitripaline (10-20mg)
Loperamide for diarrhoea
Laxatives of constipation
Two subdiagnosis of function dyspepsia
Postprandial Distress Syndrome (PDS)
&
Epigastric Pain Syndrome (EPS)
Rome diagnostic criteria for PDS
1 or both of the following for at least 3days/week:
- Bothersome postprandial fullness (i.e., severe enough to impact on usual activities)
- Bothersome early satiation (i.e., severe enough to prevent finishing a regular size meal)
AND
- No evidence of structural disease (including at upper endoscopy) that is likely to explain the symptoms
Must of filled this criteria for 3months with symptom inset >6months ago
Rome diagnostic criteria for EPS
1 or both of the following for at least 1day/week:
- Bothersome epigastric pain (i.e., severe enough to impact on usual activities)
- Bothersome epigastric burning (i.e., severe enough to impact on usual activities)
AND
- No evidence of structural disease (including at upper endoscopy) that is likely to explain the symptoms
Must of filled this criteria for 3months with symptom inset >6months ago
Treatment for functional dyspepsia?
EPS:
If pain is strong and persistant can give PPIs/H2 agonists, if these don’t work and low dose tricyclic antidepressants 10/20mg
PDS:
If severe try prokinetics (erythromycin). If still not releiving tricyclic antidepressants 10/20mg
