Duke PA Irritable Bowel Syndrome
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| IBS affects mostly | women
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| IBS peaks in the __ decade of life | 3-4th
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| onset of IBS after age __ is unusual | 50
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| IBS is characterized by | chronic abdominal pain and bloating relieved by defecation. Changes in stool frequency or appearance in the stool
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| comorbid conditions associated with IBS | Gerd, genito-urinary symptoms, fibromyalgia, headache, backache, psychological symptoms
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| patient has hard stools more than 25% of the time and loose stools less than 25% of the time | IBS-C
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| patient has loose stools more than 25% of the time and hard stools less than 25% of the time | IBS-D
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| don't do a sigmoidoscopy in a patient after the age of __ do a colonoscopy instead | 50
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| patients with IBS should not have __ | bloody stools
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| 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
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| lowered rectal __ is considered a hallmark of IBS | pain threshold
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| 50% of IBS patients who seek medical attention are __ | depressed or anxious
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| the presence or absence of a history of __ is correlated in the severity of symptoms in patients with IBS | childhood abuse
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| administration of __ was proven to exacerbate symptoms especially bloating | enteral fats
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| postinfectious IBS is seen in infection with | entamoeba, salmonella, and campylobacter
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| overall, __ appear similar to placebo in the treatment of IBS | bulking agents
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| antispasmodics: angents such as __ are thought to reduce abdominal pain or bloating through anti-cholinergic pathways | dicyclomine, hyoscyamine
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| those with constipation predominant IBS may benefit from __ | osmotic laxatives
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| data from RCT's show __ decrease global symptoms and reduce pain | antispasmodics
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| Stimulate receptors in the enteric nervous system that inhibit peristalsis and fluid secretion | anti-diarrheals
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| __ decrease stool frequency and improved consistency but not abdominal pain or global IBS symptoms | anti-diarrheals
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| Benefit of improved global symptoms seen in IBS-D but not IBS-C | antidepressants
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| RCTs show improved coping after __ but no change in bowel symptoms | psychological treatment
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| Several small, short term studies with __ most with no benefit over placebo | lactobacillus
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| Most recent trial with encapsulated probiotic __ found to be superior with improvement in global symptoms exceeding placebo by 20%. | Bifidobacterium infantis 35624
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| 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
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| 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)
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| treatment approach for mild IBS (no hinderance on daily life, no missed work or school) | patient education, reassurance, dietary recommendations
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