Podcast
Questions and Answers
Which of the following is NOT a symptom of IBS?
Which of the following is NOT a symptom of IBS?
- Diarrhea
- Abdominal pain
- Constipation
- Fever (correct)
What is the primary way IBS is diagnosed?
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?
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?
What kind of foods can contribute to IBS symptoms?
Which of the following is NOT a type of IBS based on stool patterns?
Which of the following is NOT a type of IBS based on stool patterns?
What is one of the major reasons doctors might use diagnostic tests in diagnosing IBS?
What is one of the major reasons doctors might use diagnostic tests in diagnosing IBS?
Which of the following is NOT a potential treatment option for IBS?
Which of the following is NOT a potential treatment option for IBS?
What percentage of people with IBS have a family member with the disorder?
What percentage of people with IBS have a family member with the disorder?
What is the primary purpose of keeping a diary for patients with IBS?
What is the primary purpose of keeping a diary for patients with IBS?
Which of the following therapies may help patients cope with IBS symptoms?
Which of the following therapies may help patients cope with IBS symptoms?
Which dietary strategy is encouraged for patients with IBS-C?
Which dietary strategy is encouraged for patients with IBS-C?
What is the mechanism of action of Eluxadoline in the treatment of IBS-D?
What is the mechanism of action of Eluxadoline in the treatment of IBS-D?
What is a significant side effect of Alosetron when used for IBS-D in women?
What is a significant side effect of Alosetron when used for IBS-D in women?
Flashcards
Low-FODMAP diet
Low-FODMAP diet
A diet that limits foods high in fermentable oligosaccharides, disaccharides, monosaccharides, and polyols to alleviate IBS symptoms.
Cognitive behavior therapy
Cognitive behavior therapy
A psychological treatment that helps manage IBS symptoms by changing negative thought patterns.
Probiotics
Probiotics
Live bacteria that may improve gut flora and alleviate IBS symptoms.
Antispasmodics
Antispasmodics
Medications like hyoscyamine and dicyclomine that reduce muscle spasms in the GI tract for IBS relief.
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Eluxadoline
Eluxadoline
An opioid agonist used for treating IBS-D by decreasing colonic contractions and relieving diarrhea.
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Irritable Bowel Syndrome (IBS)
Irritable Bowel Syndrome (IBS)
A disorder causing chronic abdominal pain and altered bowel patterns.
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IBS subtypes
IBS subtypes
Categories of IBS: IBS-C (constipation), IBS-D (diarrhea), mixed, and unsubtyped.
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Rome IV criteria
Rome IV criteria
Guidelines for diagnosing IBS, requiring abdominal pain/discomfort for 1 day/week over 3 months.
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FODMAPs
FODMAPs
Fermentable oligo-, di-, and monosaccharides and polyols that may worsen IBS symptoms.
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Common IBS symptoms
Common IBS symptoms
Abdominal distention, nausea, flatulence, bloating, and urgency to defecate.
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Psychologic stressors
Psychologic stressors
Factors like depression and anxiety that can contribute to IBS onset or worsening.
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Diagnosis of IBS
Diagnosis of IBS
Based on symptoms and thorough history, ruling out other disorders.
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IBS treatment
IBS treatment
Includes psychological support, dietary changes, and medications to relieve symptoms.
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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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