Term
|
Definition
- Change in frequency/consistency of bowel movements
- Bloating or GI symptoms
- Abdominal pain reduced w/ bowel movement and increased with meals |
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|
Term
| What is the pathophys of IBS? |
|
Definition
2 types of serotonin:
- Overexpression of 5-HT3 = diarrhea
- Underexpression of 5-HT4 = constipation |
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Term
|
Definition
- Manning criteria - Chronic pain for 6 months and 2+: pain relief w/ defecation, frequent stools, loose stools, incomplete evacuation, mucus, distention
- Rome III criteria - pain for 3 days/month and 2+: Improvement w/ defecation, change in frequency, change in form. |
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Term
| How are bulking agents used for IBS? |
|
Definition
Increase intestinal mass and reduce pressure. For IBS-C. Worsens bloating, psyllium is the worst
- Calcium polycarbophil/Fibercon
- Psyllium/Metamucil
- Methylcellulose/Citrucel |
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Term
| How do laxatives treat IBS? |
|
Definition
Increase motility. Use prn for the shortest duration for IBS-C
- Bisacodyl/Dulcolax
- PEG/Miralax |
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Term
| How do antidiarrheals work for IBS? |
|
Definition
delay intestinal transit and strengthen sphincter tone. For IBS-D
- Diphenoxylate/Lomotil - drug of choice
- Loperimide/Immodium |
|
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Term
| How are antispasmotics used for IBS? |
|
Definition
Inhibit muscarinic receptors for IBS-D
- Hyoscamine/Levsin
- Dicyclomine/Bentyl
- Chlordiazepoxide and Clidinium/Librax |
|
|
Term
| What 5-HT3 antagonist is used for IBS? |
|
Definition
Delays intestinal transit ONLY for women for severe IBS-D
- Alosetron/Lotronex. Serious AE: Ischemic colitis |
|
|
Term
| What 5-HT4 agonist is used for IBS? |
|
Definition
Increase GI motility ONLY for severe IBS-C in women
- Tegaserod/Zelnorm |
|
|
Term
| What is Rifaximin/Xifaxin indicated for in IBS? |
|
Definition
| A non-absorbable antibiotic for IBS after gastroenteritis |
|
|
Term
| What other treatments are available for IBS? |
|
Definition
- lubiprostone/Amitiza - for IBS-C in women
- TCAs - Amitriptyline and Desipramine - Anticholinergic effects. IBS-D w/ emotional consequences
- SSRIs - cause diarrhea, so use in IBS-C. Paxil, Zoloft, Prozac
- Linactolide/Linzess |
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