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62 Cards in this Set
- Front
- Back
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IBS
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irritable bowel syndrome
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IBD
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inflammatory bowel disease
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_____ is a chronic unexplained abdominal pain with altered stools. Very common cause of physician visits (10% of PCP visits) & missed work
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IBS
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is IBS more common in women or men
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women
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how long does IBS last
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usually life long
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IBS is characterized by increased ______________
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bowel motility, especially after meals,
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IBS is blocked by ___________
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anti-cholinergic drugs
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IBS pts have increased bowel sensitivity ____________
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to pain, but not increased non-GI pain sensitivity
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In IBS there is increased retention and perception of intestinal ____
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gas
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IBS is associated with altered ____ activity with bi-directional involvement
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CNS
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IBS
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irritable bowel syndrome
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IBD
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inflammatory bowel disease
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_______ and the _________ regulate bowel function and perception
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CNS
enteric nervous system |
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IBS may present _________
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post-enteric infection
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5-HT (serotonin) is primarily in _______
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GI tract
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5-HT subtypes regulate ________ and ______ in GI tract
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motility
sensation |
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______ agonists and antagonist drugs are main focus of IBS clinical drug research
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5-HT
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New onset of symptoms in patients 50+ years indicates
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“Red flag” ---may suggest an alternative or coexisting diagnosis to IBS
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Anemia
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“Red flag” ---may suggest an alternative or coexisting diagnosis to IBS
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Fever
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“Red flag” ---may suggest an alternative or coexisting diagnosis to IBS
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Persistent diarrhea
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“Red flag” ---may suggest an alternative or coexisting diagnosis to IBS
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Rectal bleeding
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“Red flag” ---may suggest an alternative or coexisting diagnosis to IBS
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Severe constipation
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“Red flag” ---may suggest an alternative or coexisting diagnosis to IBS
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Weight loss
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“Red flag” ---may suggest an alternative or coexisting diagnosis to IBS
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Nocturnal pain & abnormal bowel fxn
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“Red flag” ---may suggest an alternative or coexisting diagnosis to IBS
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Family history of GI CA, IBD, or celiac disease
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“Red flag” ---may suggest an alternative or coexisting diagnosis to IBS
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_______ most often appears in adulthood with symptoms similar to IBS
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Celiac disease
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_______ is a genetic immune intolerance to wheat (gluten) and similar cereals
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Celiac
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Diagnosis of celiac dz is suspected by _______
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anti-body tests (endomysial or tissue transglutaminase)
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Treatment for celiac is _______
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life-long gluten-free diet
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Treatment of IBS includes :
Patient ___________ |
communication & education
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Treatment of IBS includes :
__________ only if inciting foods identified |
Dietary
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Treatment of IBS cludes :
PRN Rx with __________ |
anti-diarrheals (loperamide)
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Treatment of IBS includes :
PRN _______ for spasm |
anti-cholinergics
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Treatment of IBS includes :
Bulk & osmotic (no stimulants) _______ |
laxatives
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Treatment of IBS includes :
PRN _______ for “gate” to reduce pain |
tricyclics
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Treatment of IBS includes :
_________ drugs – looks promising! |
5-HT3 and 5-HT4
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Treatment of IBS includes : ________ for temporary relief?
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Antibiotics
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IBD onset is most common in ________, in the _________
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young adults
industrialized northern hemisphere |
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__________ has diffuse mucosal inflammation limited to the colon
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Ulcerative colitis
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_________ has patchy, transmural inflammation anywhere in the GI tract
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Crohn’s disease
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__________ are uncommon complications of UC
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Megacolon & perforation
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Mucosal inflammation & crypt abscesses occur with
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UC
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__________ are the most common symptoms
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Bleeding & diarrhea
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________increase > 7 yrs with UC
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Colon dysplasia & cancer
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___________ often related to UC
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Sclerosing cholangitis
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This IBD is characterized by aphthous & stellate ulcers & skip areas. Transmural, strictures, fistulas, perforations. Perianal disease is common
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CD
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CD is often _______, but can also occur anywhere in GI tract
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ilial
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In CD, _______ is seen at surgery
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Creeping fat
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Complications of both UC & Crohns:
Colon inflammatory _______ Osteopenia and _________ Inflammatory ________ E. nodosum & pyoderma _______ Episcleritis and ________ |
“pseudo-” polyps
osteoporosis arthritis grangrenosum uveitis |
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Childhood Onset of IBD: Is often atypical presentations with ________(4)
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fever, anemia, arthritis, or growth failure
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Theories on cause of IBD:
Genetic + exposure to luminal antigens, trigger an uncontrolled immune response & release of ________ |
cytokines (e.g. IL-1)
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______ drugs are the main treatment & safest treatment for IBD
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5-ASA
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_________ are used primarily to induce remission in IBD
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Steroids
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alternatives to steroids for IBD
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6 M-P & azathioprine
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Infliximab primarily for _____
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Crohn’s
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Surgery cures _______
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UC, not Crohn’s
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This other cause of colitis & enteritis is characterized by chronic watery diarrhea with normal gross appearance
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Microscopic colitis –
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This other cause of colitis & enteritis is characterized by acute onset, many PMS’s
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Infectious colitis –
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This other cause of colitis & enteritis resembles Crohn’s
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NSAIDs colitis
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This other cause of colitis & enteritis is characterized by prevolence in watershed areas
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Ischemic colitis
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This other causes of colitis & enteritis is characterized by no inflammation
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IBS –
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