Irritable Bowel Syndrome Overview

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Questions and Answers

Which of the following is NOT a symptom of IBS?

  • Diarrhea
  • Abdominal pain
  • Constipation
  • Fever (correct)

What is the primary way IBS is diagnosed?

  • Colonoscopy
  • Blood tests
  • Patient symptoms (correct)
  • Endoscopy

Which of the following is a psychological stressor associated with IBS?

  • Poor diet
  • Anxiety (correct)
  • Lack of sleep
  • Extreme exercise

What kind of foods can contribute to IBS symptoms?

<p>Foods high in FODMAPs (A)</p> Signup and view all the answers

Which of the following is NOT a type of IBS based on stool patterns?

<p>IBS with gas (IBS-G) (B)</p> Signup and view all the answers

What is one of the major reasons doctors might use diagnostic tests in diagnosing IBS?

<p>To identify any underlying causes of IBS (C)</p> Signup and view all the answers

Which of the following is NOT a potential treatment option for IBS?

<p>Antibiotics (D)</p> Signup and view all the answers

What percentage of people with IBS have a family member with the disorder?

<p>10-20% (D)</p> Signup and view all the answers

What is the primary purpose of keeping a diary for patients with IBS?

<p>To identify factors that trigger IBS symptoms (C)</p> Signup and view all the answers

Which of the following therapies may help patients cope with IBS symptoms?

<p>Cognitive behavior therapy (C)</p> Signup and view all the answers

Which dietary strategy is encouraged for patients with IBS-C?

<p>High-fiber diet (B)</p> Signup and view all the answers

What is the mechanism of action of Eluxadoline in the treatment of IBS-D?

<p>Decreases colonic contractions (C)</p> Signup and view all the answers

What is a significant side effect of Alosetron when used for IBS-D in women?

<p>Severe constipation (B)</p> Signup and view all the answers

Flashcards

Low-FODMAP diet

A diet that limits foods high in fermentable oligosaccharides, disaccharides, monosaccharides, and polyols to alleviate IBS symptoms.

Cognitive behavior therapy

A psychological treatment that helps manage IBS symptoms by changing negative thought patterns.

Probiotics

Live bacteria that may improve gut flora and alleviate IBS symptoms.

Antispasmodics

Medications like hyoscyamine and dicyclomine that reduce muscle spasms in the GI tract for IBS relief.

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Eluxadoline

An opioid agonist used for treating IBS-D by decreasing colonic contractions and relieving diarrhea.

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Irritable Bowel Syndrome (IBS)

A disorder causing chronic abdominal pain and altered bowel patterns.

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IBS subtypes

Categories of IBS: IBS-C (constipation), IBS-D (diarrhea), mixed, and unsubtyped.

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Rome IV criteria

Guidelines for diagnosing IBS, requiring abdominal pain/discomfort for 1 day/week over 3 months.

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FODMAPs

Fermentable oligo-, di-, and monosaccharides and polyols that may worsen IBS symptoms.

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Common IBS symptoms

Abdominal distention, nausea, flatulence, bloating, and urgency to defecate.

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Psychologic stressors

Factors like depression and anxiety that can contribute to IBS onset or worsening.

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Diagnosis of IBS

Based on symptoms and thorough history, ruling out other disorders.

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IBS treatment

Includes psychological support, dietary changes, and medications to relieve symptoms.

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Study Notes

Irritable Bowel Syndrome (IBS)

  • IBS is a chronic disorder causing abdominal pain and altered bowel habits.
  • Common symptoms include diarrhea, constipation, or a mix of both.
  • Women are affected 2-2.5 times more often than men.

Cause and Contributing Factors

  • No definitive cause is known.
  • Psychological stressors (depression, anxiety, etc.) can exacerbate symptoms.
  • Family history of IBS is a risk factor.
  • GI infections and food intolerances (like gluten and FODMAPs) can contribute.

FODMAPs and Food Intolerances

  • FODMAPs (fermentable oligo-, di-, and monosaccharides and polyols) are often implicated in IBS.
  • Examples include wheat, rye, certain fruits/vegetables (onions, garlic, legumes, nuts), milk products (lactose), honey, apples, pears, and high-fructose corn syrup.
  • Polyols are present in various foods, including apples, pears, stone fruits, cauliflower, mushrooms, and artificial sweeteners (sorbitol).

Diagnosis

  • Diagnosis relies on symptoms alone, using the Rome IV criteria.
  • These criteria require abdominal pain/discomfort at least once a week for 3 months, associated with 2 or more of: related to defecation, change in stool frequency, and change in stool form.

IBS Subtypes

  • IBS is categorized by stool patterns:

    • IBS-C (constipation)
    • IBS-D (diarrhea)
    • IBS mixed
    • IBS unsubtyped
  • Other common symptoms include abdominal distension, nausea, flatulence, bloating, urgency, mucus in stool, and sensation of incomplete evacuation.

  • Non-GI symptoms include fatigue, headache, and sleep problems.

Diagnostic Approach

  • A thorough history (including psychosocial factors, family history, diet, and medication history) and physical assessment are crucial.
  • Determine how IBS impacts daily activities (school, work, social).
  • Diagnostic tests rule out other conditions like Crohn's disease, ulcerative colitis, endometriosis, and malabsorption disorders.

Management of IBS

  • No single treatment is universally effective.
  • Treatment strategies include:
    • Psychological support (cognitive behavioral therapy, stress management techniques).
    • Diet and lifestyle modifications (symptom diary, stress management, regular exercise).
    • Medications to regulate stool output and reduce discomfort.

Dietary Recommendations

  • Keep a symptom diary to identify triggers.
  • Follow a low FODMAP diet to reduce symptoms.
  • Avoid gas-producing foods (e.g., broccoli, cabbage) for those experiencing flatulence issues.
  • High-fiber diet may help manage IBS-C, aiming for soft, painless bowel movements.
  • Dairy may trigger symptoms in some; consider yogurt (due to lactobacillus).
  • Probiotic supplements can sometimes improve symptoms.

Drug Therapies

  • Medications target the predominant symptoms (pain, stool type).
  • Antidepressants and antispasmodics (hyoscyamine, dicyclomine) are often beneficial for all IBS patients.
  • Antispasmodics decrease gastrointestinal motility and smooth muscle spasms.
  • IBSD treatment options include rifaximin, eluxadoline, and alosetron.
  • Eluxadoline reduces colonic contractions.
  • Alosetron is reserved for severe IBS-D unresponsive to other treatments (restricted access due to side effects).
  • Rifaximin is a short-term treatment (2-week courses).
  • Loperamide can help some patients.
  • IBS-C medications include linaclotide and lubiprostone.
  • Linaclotide has mechanical obstruction and prior bowel surgery contraindications.
  • Lubiprostone is beneficial for women with IBS-C.

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