GIT IBS abstract form.


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Irritable bowel syndrome.

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GIT IBS abstract form.

  1. 1. LOGO Irritable Bowel syndrome: Dr.Mohamed Shekhani
  2. 2. Contents 1 3 Epidemiology 2 Pathophysiology 3 Diagnostic crieteria 4 Management
  3. 3. Epidemiology:  A common disorder  7% prevalence.  Women * 1.5 >men  Most commonly between 20-40 years.  Onset after the age of 50 years is uncommon.  IBS is costly, with direct& indirect costs at $20 billion.  Consume > 50% more in health care resources than matched controls.
  4. 4. Pathogenesis: Not well understood Psychological factors Depression Anxiety H/O sexual abuse, Phobias Somatization Somatic abnormalities Abnormal GIT motility Visceral afferent hypersensitivity Autonomic innervation abnormalities. Altered mucosal immune system activation
  5. 5. Diagnosis: no diagnotic marker Positive diagnosis: Abd pain/or Discomfort For 3/30, 3/12 + 2 0r > Absence of red flags Excess gasses& mucus Rome Criteria Change stool consistency Change stool Frequency
  6. 6. Re Flags: 1 Age >50 years Male Short history of symptoms 2 Documented weight loss Nocturnal symptoms Rectal bleeding Recent antibiotic use Family history of CRC. 3
  7. 7.
  8. 8. Diagnosis: Rome criteria 20-50 years > females No red flags
  9. 9. Diagnosis: Rome sensitivity 71% specificity 85%. Infections DD: is wide IBD Drugs Foods intolerance or allergy Gynecological etc
  10. 10. Diagnotic testing: Only if alarm Features present 3.Colonoscopy if Done for screeing Biopsies taken to exclude microcolitis. 2.H breath test For lactasia def If cli suspicion is high & After diet exclusion fails Except 1.celiac serology For IBS-D or IBS-M.
  11. 11. Diagnostic studies: Routine Blood tests Blood Bio If red flags Present TFTs Celaic serology Colonoscopuy imagings IBD Serology Stool exams
  12. 12. Mnagement: no cure,symptoms trts Mild: Education,reassurance,diet Moderate: pharmacotherapy & psychiatric interventions Severe: multidisplinary& referral to pain centers Good doctor-patient relationship
  13. 13. IBD-C: Laxatives Bulking,Stimulants, Osmotic,emolionts. Serotoin modulators Increase fibers Tegaseroid CVD risk Vegetables/fruits
  14. 14. IBD-C: Cl channel activator Lubiprostone For: 1.IBS-C in women 2.Idiopathic C in men/women
  15. 15. IBD-D: AntiDiarrheal Diphenoxylate Loperamide TAD Antibiotics Greater efficacy In IBD-D Rifaximin
  16. 16. IBD-D: 5 HT Antagonists Alosetron For IBS-D Only for women S/Es: constipation& ischemic colitis
  17. 17. IBD-Abd pain/Bloating: Antispasmotics Hyosin,Mebeverin, Specially for PPP. TAD IBS-D Lower doses than for depression SSRIs Improvement in Well being.
  18. 18. LOGO