Irritable Bowel Syndrome

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Gastroenterology Fichas sobre Irritable Bowel Syndrome, creado por Jenna Paterson el 21/10/2020.
Jenna Paterson
Fichas por Jenna Paterson, actualizado hace más de 1 año
Jenna Paterson
Creado por Jenna Paterson hace alrededor de 4 años
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What are the symptoms of IBS? Abdominal pain or discomfort that is relieved by defecation or associated with altered bowel frequency or stool form. This should be accompanied by at least 2 of the 4 following symptoms: ○ Altered stool passage (straining, urgency, incomplete evacuation) ○ Abdominal bloating (more common in women), distension, tension or hardness ○ Symptoms made worse by eating ○ Passage of mucus
What are red flag features of upper GI cancer? Patients with dysphagia OR aged 55 and over with weight loss and any of the following: - Upper abdominal pain - Reflux - Dyspepsia
What are red flag features of lower GI cancer? - Unexplained weight loss - Unexplained rectal bleeding - IDA - Positive faecal occult blood testing
What are the 3 options for IBS management, broadly speaking? - Dietary and Lifestyle Advice - Pharmacological Therapy - Other Treatments
What dietary advice can be given to someone with IBS? - Have regular meals and avoid missing meals - Drink at least 8 cups of fluid/day - restrict caffeine - tea/coffee/fizzy drinks and alcohol - Limit fresh fruit to 3 portions per day - Oats can help bloating - Reduce intake of resistant starch, often found in processed or re-cooked foods - If symptoms persist try single food avoidance and exclusion diets (e.g. a low FODMAP diet)
What pharmacological agents can be used to manage IBS? 1st line: - Antispasmodic - hyoscine butylbromide - for abdominal pain - Laxatives - but not lactulose - for constipation - Loperamide - anti-motility for diarrhoea - 2nd line - Tricyclic antidepressants (TCAs) - SSRIs if TCAs are ineffective
What can you do if someone isn't responding to dietary/lifestyle advice and pharmacological therapy after 12 months with symptoms persisting? - Psychological interventions ○ CBT ○ Other psychological therapy
Define IBS A syndrome/group of symptoms, which can cause chronic abdominal pain or discomfort, diarrhoea and constipation.
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