Question | Answer |
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 |