Irritable Bowel Syndrome And Irritable Bowel Disease Exam | Questions & Answers (100
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What is Irritable Bowel Syndrome ( IBS?) - ✔✔chronic functional disorder, symptoms are intermittent
and include abdominal pain or discomfort and alterations in bowel patterns, report history of gi
infection and food intolerances
~oligo, di, monosacchardies and polyols: fructans galactans,fructose,soribitol and xylitol
~psychological stressors
~more common in women
abdominal distention, excessive flatuelence, belching, bloating ,urgency, sensation of incomplete
evacuation, fatigue and sleep disturbances,diarrhea and constipation
~H + P to diagnose
~Treatment is directed at psychologic and dietary factors and drugs to regulate stool output, encourage
patient to verbalize concerns
~fiber intake 20 g/day or bulking agent
~Avoid gas foods like broccoli and cabbage, yogurt better than milk
IBS drugs - ✔✔Loperamide: opioid that slows intestinal transit used to treat diarrhea when occurs
Alosetron (lotronex), a serotonergic antagonist is used for IBS patients~ restricted for women who have
not responded to other therapies 6 months , firmeness in stools and decreased urgency and frequency
of defecation [ pt to report constipation, malaise, darken urine, bleeding from rectum/stool]
Lubiprostone (amitzia): constipation in women, increases fluid secretion in intestine to promote
intestinal motility, contraindicated for those with bowel obstruction; take with food to decrease nausea
Linaclotide (linzess: constipation men and women
Inflammatory Bowel Disease, what is it? - ✔✔chronic inflammation of GI tract, period of remission
interspersed with periods of exacerbation
, IBD is classifed as either ____ or ____ - ✔✔Ulcerative Colitis or Crohn's
Ulcerative Colitis is limited to the - ✔✔colon
Crohn's can involve ____ segment of gi tract from____ to ____ - ✔✔any, mouth to anus
Both Ulcerative Colitis and crohn's commonly occur during ___ but peak during ____ - ✔✔teenage years
early adult hood, but peak in sixth decad
IBD is more prevalent in - ✔✔industrialized countries and ash kenazi jews
IBD Etiology and Patho - ✔✔Ibd is an autoimmune disease involving an immune reaction to a person's
own intestinal tract, some agent or a combination of agents triggers an overactive, inappropriate,
sustained immune response: widespread tissue destruction
RF Of IBD - ✔✔~environmental: diet, hygiene, stress, smoking, nsaids
~diet: high intake of fats, polyunsaturated fatty acid , omega 6 and meat
~genetic
~high fiber and fruit decreased crohns, vegetable intake decrease ulcerative colitis
Crohn's pattern of inflammation - ✔✔all layers of bowel wall, can occur anywhere in the gi tract,
commonly in the TERMINAL ileum and colon
~skip lesions: healthy portions
~ulcerations deep and longitudinal, penetrate between islands of edematous mucosa: cobblestone
appearance
~strictures can cause obstruction
~fistulas develop between adjacent areas of bowel, between bowel and bladder, and between bowel
and vagina
~uti are first sign of bowelbladder fistula, feces is seen in urine
