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16 Cards in this Set
- Front
- Back
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What is irritable bowel syndrome?
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abdominal pain associated with defecation or a change in bowel habit, disordered defecation and distension
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What are the subtypes of IBS?
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diarrhea, constipation predominant, alternating bowel habits
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What are the criteria for IBS?
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pain with defecation, change in frequency or consistency of stool, bloating, passage of mucus
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What else do you consider around IBS?
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lactose intolerance, parasitic infection, inflammatory bowel disease, colonic neoplasia, celiac disease
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What are the psychosocial factors around IBS?
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stress, anxiety, somatization, hostility, phobia, problems iwth coping, learned illness behavior, sexual or physical abuse history
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What luminal pathophysio factors exist?
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lactose malabsorption, bile acids, short-chain FAs, food allergens
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How do you investigate diarreha predominant IBS?
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trial of dairy product avoidance, lactase suplements, loperamide, diphenoxylate
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How do you treat intractable diarrhea predominant IBS?
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jejunal aspirate, stool analysis, serologic screen for celiac, small bowel or colonic
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How do you investigate constipation predominant IBS?
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therapeutic trial with fiber/osmotic laxative, review diet history
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What do you do for constipation predominant IBS?
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colonic transit study, anorectal manometry, defecating proctography
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What do you do for IBS-related pain/gas/bloating?
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review diet history, plain abdominal films, therapeutic trial of antispasmodics
low dose tricyclic antidepressant |
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What do you do for intractable pain/gas/bloating?
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SB radiograph, SB manometry
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What do you advise for diet in IBS?
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high fiber, low fat, generous fluid itnake, regular exercise
avoid dairy, fructose, sorbitol |
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What do you give for diarrhea predominant IBS?
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loperamide, diphenoxylate, cholestyramine, Ca channel blockers
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What do you give for constipation predominant IBS?
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fiber supplements, osmotic laxatives
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What do you give for postprandial IBS symptoms?
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anti-cholinergics
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