Criado por Jenna Paterson
aproximadamente 4 anos atrás
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Questão | Responda |
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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