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9 Cards in this Set
- Front
- Back
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What is irritable bowl syndrome? |
Is a functional GI disorder that is characterised by abdominal pain and disordered defecation. there is no biological marker/signs that can point to a diagnosis |
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What are the typical signs and symptoms of IBS? |
Think ABC A. Abdominal pain: varied locations and relieved by defecation or passing wind B. Bloating: is usually worse by the end of the day and produces offensive wind C. Change of bowl habits: diarrhoea or constipation or a mixture of both Mental health: 40-60% of people suffering IBS have anxiety or depression |
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How is the diagnosis of IBS achieved? |
Hard to diagnose due to lack of biological marker. The symptoms must be in the Rome III criteria for IBS which include: -Recurrent abdominal pain or discomfort and a marked change in bowel habit in the last 6 months With 2 more of the following: - Pain is relieved by defecation - Onset of pain is associated with a change in frequency of stools - Onset of pain is associated with a change in the appearance of stools. |
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What are the 3 sub classifications of IBS? |
1. Diarrhoea predominant D-IBS 2. Constipation predominant C-IBS 3. Pain predominant P-IBS |
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What are the alarm sympotoms for IBS? i.e. symptoms that indicated a condition other than IBS |
- Onset of symptoms later in life (40+) - Frequent nocturnal waking with symptoms - family history of colon cancer, IBD - Recurrent vomiting - Persistent diarrhoea - Sever constipation - Rectal bleeding - Fever - Unexplained weight loss |
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What is the treatment of P-IBS? |
Anti-spasmotic agent: Hyoscine butylbromide 20mg qid OR Mebeverine 135mg tds OR Peppermint oil 0.2ml/cap - 2 caps tds Antidepressants: TCA - also have anticholinergic properties which may reduce diarrhoea Amitriptyline OR nortryptline 12.5-25 mg nocte then slowly increase SSIR- rarely used no real evidence Citalopram 20mg d |
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What is the treatment of C-IBS? |
Fibre products: - Methylcellulose, psyllium, course bran - May aggravate symptoms initially, start small and build up over 3-4 weeks Osmotic laxitives: - Lactulose, sorbitol Stimulants - Senna |
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What is the treatment of D-IBS? |
Use agents that slow colinonic transit - Loperamide 4-8mg dd MAX 16mg daily - Diphenoxylate 2.5mg/atropine 25mcg 2 tablets tds to qid Can trial increasing the consumption of feed that produce faecal mass |
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What is the treatment for IBS when the primary complaint is bloating? |
Anticholinergic agents hyoscyamine butylbromide 20mg qid lifestyle changes: consume low gas producing foods low FODMAP diet |
