IBS

Question 1

What symptoms will pts experience with IBS?

Answer 1

Alternating symptoms of diarrhoea, constipation, abdominal distension/bloating and discomfort

Question 2

Cautions and when to refer?

Answer 2

• children under 16
• older adult (over 45 years)
• loss of appetite
• Fever
• N/V
• Rectal bleeding may indicate inflammatory bowel disease, gastric ulcer or gastric carcinoma
• weight loss

Question 3

What tx for IBS

Answer 3

Antispasmodics - mebeverine/ peppermint oil/alverine citrate - work by relaxing the smooth muscle in the gut, thereby reducing ab pain
Antimuscarinics - hyoscine, dicycloverine also relax smooth muscle
bulking agents - ispaghula

Question 4

What are commonly used OTC preps?

Answer 4

Colofac, Colpermin, Buscopan, Kolanticon

Question 5

Counselling points?

Answer 5

symptoms can be prevented by minimising certain foods and additives including caffeine, alcohol, dairy products, artifical sweeteners

Question 6

What age restrictions are on the following:
 - Hyoscine 
- Mebeverine 
- Peppermint oil 
Alverine

Answer 6

Hyoscine - >6 years
Mebeverine > 10 years
Peppermint oil > 15 years
Alverine >12 years

Question 7

Are the tx options safe to use in pregnancy and Bf?

Answer 7

Yes but avoid in hyoscine

Avoid BF with peppermint oil