IBS

Question 1

What is IBS?

Answer 1

Functional bowel disorder

Question 2

What does a functional bowel disorder mean?

Answer 2

• No identifiable organic disease

- Diagnosis of exclusion

Question 3

What percentage of the population have IBS?

Answer 3

20%

Question 4

Which gender is most commonly affected?

Answer 4

Women

Question 5

How does IBS present?

Answer 5

• Abdo pain/bloating

- Diarrhoea/constipation (Fluctuates)

Question 6

What relieves the pain in IBS?

Answer 6

Opening bowels

Question 7

What worsens the pain in IBS?

Answer 7

Eating

Question 8

What must be unremarkable for a diagnosis of IBS?

Answer 8

• Full profile
• Faecal calprotectin
• anti-TTG antibodies

Question 9

What must be present for IBS to be diagnosed?

Answer 9

• Abdo pain with bowel habit change

and 2 of:

• Bloating
• Eating exacerbates
• abnormal stools
• mucus in stools

Question 10

How is IBS conservatively managed?

Answer 10

• Regular small meals
• Limit caffeine and alcohol
• Low FODMAP diet
• Probiotics

Question 11

What is FODMAP?

Answer 11

Short-chain carbs

Question 12

What medications are first line in IBS?

Answer 12

Loperamide- diarrhoea
Linaclotide/laxative- constipation
Buscopan- cramps

Question 13

What is the active drug in Buscopan?

Answer 13

Hyoscine butylbromide

Question 14

What are the second and third line meds in IBS?

Answer 14

2nd- tricyclicanti-depressants (amitryptyline)

3rd- SSRIs

Question 15

How is CBT used in IBS?

Answer 15

Reduce the stress associated with the symptoms

Question 16

What is the principle of IBS management?

Answer 16

Find the patients’ preferred state between diarrhoea and constipation

Question 17

What does this describe?

‘Sometimes I get bloated. It can last several days, and if I go to sleep bloated, I will wake up bloated.’

Answer 17

IBS

Question 18

What does this describe?

‘When I wake up, my tummy is flat. As I go through the day, it gets more bloated. When I go to sleep, it will flatten again.’

Answer 18

Constipation

Question 19

What is constipation overflow and how does it present?

Answer 19

Watery diarrhoea
- Constipation promotes the release/leak of water into the GI lumen to flush it/go around the blockage

• Do not use anti-diarrhoeals e.g. loperamide with this