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22 Cards in this Set
- Front
- Back
Symtpoms |
abdominal discomfort and pain. bloating, mucous in stools, diarrhoea, constipation or alternating diarrhoea and constipation. depression, anxiety or stress. |
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IBS can be subdivided into |
Diarrhoea predominant constipation- predominant alternating diarrhoea and constipation |
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what is IBS |
A group of functional bowel disorders. chronic abdominal complaints without a structural or biochemical cause. cause is unknown. more frequent in women. |
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supportive symptoms of ibs |
fewer than 3 bowel movements a week more than 3 bowel movements a day hard or lumpy stools loose or watery stools urgency feeling of incomplete bowel movement passing mucus during a bowel movement abdominal fullness, bloating or swelling |
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diarrhoea predominant IBS |
One or more of: loose or watery stools. feeling of incomplete bowel movement. none of: hard or lumpy stools urgency |
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constipation predominant IBS |
One or more of hard or lumpy stools urgency none of: loose or water stools feeling of incomplete bowel movement |
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rome ii criteria. |
IN the last three months did u have discomfort in abdomen. if yes: when the discomfort or pain started, did you have a change in the usual number of bowerl movement. when the discomfort or pain started, did you have either softer or harder stools? if two of the above three symptoms are presesnt and signs are absent the diagnosis is IBS |
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stool = lumpy suggets stool = liquid/runny suggets |
lumpy = slow intestinal transit liquid= fast transit. |
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diagnosis |
only be diagnosed by symptoms. abdom pain, altered and unpredictable bowel habits and blaoting. |
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red flags |
unintentioanl weight loss rectal bleeding family history of bowel or ovarian cancer. bowerl habit change for >6 weeks in person voer 60. assess anemia, abdom masses, rectal masses, inflammator markers for inflammatory bowel disease |
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establishing a diagnosis |
Consider IBS diagnsosis only if the person has abdominal pain that is relieveed by defaecation or associataed with altered bowel frequency or stool form, and at least two symptoms form: abdominal bloating, distention, tension or hardness. symtpoms made worse by eating passage of mucus |
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diagnositic tests |
In people who meet the bs diagnostic criteria, the following tests should be undertaken to exclude other diagnoses Full blood count. erhtorycte sedimentation rate or plasma viscosity c-reactive protein antobodiy testing for coeliac disease. |
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drugs used in Ul for IBS |
anticholinergic, antispasmodicn antidiarrhoeals. |
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anticholinergics |
hyoscine |
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antispasmodics |
alverine |
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antidiarrhoeals |
loperamide. |
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loperamide |
u-opiod receptor agonist. decreases the activity of the myenteric plexus which decreases the motility of teh circular and longitudunal smooth muscles of the intestinal wall increases teh amount of time substances stay in the intestine, allowing for more water to be absorbed out of the faecal matter |
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clinical management of IBS |
dietary and lifestlye advice. fibre intake review, adjusting (usually reducing ) it while monitoring the effects on smtpoms. if symptoms persis after lifestyle dietary advice consider referally to a dieticain |
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clinical mananagment pharmacological |
Advise people with ibs on how to adjust their doeses of laxataives or antimotility agnets. dose should be titrated to sctool consistentcy aiming for a soft well-formed stool. Healthcare professionals should consider : treatment should be started at a low dose (5-10mg of amityprtiline) which should be taken once at night and reviewd reguarly. can be icnreased but doesnt need to exceed 30mg |
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physiological factors |
stress! |
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serotonin in gut function |
GI disorders may be related to: -improper reaction of the digestinve system to serotonin -faulty communication network between serotonin in the gut and the brain and spinal cord. plays a major role in modulatin intestinal movement and perception of pain helps to soften stools by releasing water |
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