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Duke PA Irritable Bowel Syndrome

IBS affects mostly women
IBS peaks in the __ decade of life 3-4th
onset of IBS after age __ is unusual 50
IBS is characterized by chronic abdominal pain and bloating relieved by defecation. Changes in stool frequency or appearance in the stool
comorbid conditions associated with IBS Gerd, genito-urinary symptoms, fibromyalgia, headache, backache, psychological symptoms
patient has hard stools more than 25% of the time and loose stools less than 25% of the time IBS-C
patient has loose stools more than 25% of the time and hard stools less than 25% of the time IBS-D
don't do a sigmoidoscopy in a patient after the age of __ do a colonoscopy instead 50
patients with IBS should not have __ bloody stools
balloon distension studies of the rectosigmoid colon and ileum show patients with IBS __ experience pain and bloating at balloon volumes and pressures significantly lower than thos that induce pain in controls
lowered rectal __ is considered a hallmark of IBS pain threshold
50% of IBS patients who seek medical attention are __ depressed or anxious
the presence or absence of a history of __ is correlated in the severity of symptoms in patients with IBS childhood abuse
administration of __ was proven to exacerbate symptoms especially bloating enteral fats
postinfectious IBS is seen in infection with entamoeba, salmonella, and campylobacter
overall, __ appear similar to placebo in the treatment of IBS bulking agents
antispasmodics: angents such as __ are thought to reduce abdominal pain or bloating through anti-cholinergic pathways dicyclomine, hyoscyamine
those with constipation predominant IBS may benefit from __ osmotic laxatives
data from RCT's show __ decrease global symptoms and reduce pain antispasmodics
Stimulate receptors in the enteric nervous system that inhibit peristalsis and fluid secretion anti-diarrheals
__ decrease stool frequency and improved consistency but not abdominal pain or global IBS symptoms anti-diarrheals
Benefit of improved global symptoms seen in IBS-D but not IBS-C antidepressants
RCTs show improved coping after __ but no change in bowel symptoms psychological treatment
Several small, short term studies with __ most with no benefit over placebo lactobacillus
Most recent trial with encapsulated probiotic __ found to be superior with improvement in global symptoms exceeding placebo by 20%. Bifidobacterium infantis 35624
Major regulator of the peristalsic reflex and sensory relays in the gut through 5HT3 and 5HT4 receptors. No longer on the market in the US Zelnorm
locally acting selective chloride-channel activator that enhances chloride-rich fluid secretion into the intestinal lumen. Approved by FDA for use in IBS-C Lubiprostone (amitiza)
treatment approach for mild IBS (no hinderance on daily life, no missed work or school) patient education, reassurance, dietary recommendations
Created by: bwyche