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16 Cards in this Set
- Front
- Back
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Recurrent abdominal pain or discomfort at least 3 days/ month in past 3 months associated with 2 or more of following:
Improvement with defecation Onset associated with change in frequency of stool Onset associated with change in appearance of stool Symptoms present for 3 months with onset at least 6 months prior .... what does this describe? Is it more common in men or women? |
IBS
- women |
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Those with ___demonstrate a more intense gut responses to food, CCK, pentagastrin , stress and rectal distention
The responses include increased ______in the both the small and large intestine These responses are modulated by neurotransmitters, gut opiate receptors and myoelectric responses |
IBS, motility
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Do pts w/ IBS have an exaggerated motor response to intrinsic or extrinsic stimuli?
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Both.
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Are the abnormal motility patterns in IBS associated with abdominal cramps? Are these patterns pathonomic for IBS? If not, what else can cause them?
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sometimes.
No; obstruction, psuedoobstruction, etc. |
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IBS and FGIDs are characterized by (high/low) sensation threshold to rectosigmoid luminal distention?
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high - visceral hypersensititvity
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Do IBS pts differ from controls in their response to somatic pain? What about pain from rectal distentions?
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No
Yes; their area of pain referral is larger. |
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What is the brain-gut axis? Two components?
What are the two potential causes of Sx involving this axis? |
complex of two neural systems: intrinsicly - by the Enteric Nervous System (ENS) and extrinsicly by autonomic nervous system spinal cord, brain stem and the cerebral cortex.
These two neural networks interact with each other to establish a what is called the Brain-Gut Axis. - afferent sensory signals arising from a diseased or malfunctioned gut - dysregulation at any level of the gut control mechanism |
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What is the most important first step in IBS diagnosis?
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Identify dominant sx --> this is what will drive our sx-based tx later on in the process.
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What are some of the dx criteron for IBS?
Are these features essential for the dx? |
<3/week or >3/day (BM)
abnormal stool form abnormal stool passage extra mucus bloating/abdominal distention No. |
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Is IBS a static dz?
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No, a chronic dynamic one, the sx and relative contrib of brain vs gut changes over time.
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Name the sx that the following meds are used to tx in IBS:
Fiber TCAs Alosetron SM relaxants SSRIs Antidiarrheals Laxatives Lubiprostone Tegaserod |
Pain
Smooth muscle relaxants TCAs SSRIs Diarrhea Antidiarrheals Smooth muscle relaxants TCAs Alosetron Constipation Fiber Laxatives Lubiprostone Tegaserod |
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What are synthetic opioids used for in IBS?
- what additional effect can high doses have on the anal sphincter? - what is the major txpeutic diff b/t loperamide and diphenoxylate? |
to tx diarrhea and the urgency associated with IBS
- increase the internal anal sphincter tone - Loperamide does not cross the BBB --> no sedation. |
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What is Alosetron?
- when is it used in IBS? - why is it's use restricted? |
- 5HT3 receptor antagonist
- diarrhea refractory to other txt - reports of ischemic colitis |
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What role do anticholinergics like peppermint oil and smooth muscle relaxants have in the tx of IBS?
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Block the exaggerated colonic contractions associated with meals and stress
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What are TCA and SSRIs? Why are they used in tx for IBS?
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Tricyclic antidepressants and selective serotonin reuptake inhibitors:
- target the CNS, part of the brain-gut axis. |
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Is there a cure for IBS?
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no.
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