Define irritable bowel syndrome (IBS) - ✔✔Chronic, functional bowel disorder characterized by
discomfort associated with changes in bowel movements
What are four risk factors for IBS? - ✔✔- Younger age (< 50 y/o)
- Female
- Smoking
- Psychological stress
Why is IBS more common in women? - ✔✔Unknown
May be related to: hormonal factors, behavioral stress response, changes in gut micro biome,
psychological factors, visceral hypersensitivity, differing medical care-seeking behaviors
When are symptoms most common? - ✔✔Women - late teens to mid-forties then decreases and
increases again around age 70
Men - constant from 20-10 years old
Macth IBS-C and IBS-D to which sex it is more common in: Male or Female - ✔✔IBS-C is more common
in women
IBS-D is more common in men
What are two broad categories of causes of IBS? - ✔✔Environmental Contributors and Host Factors
What are environmental contributors to IBS? - ✔✔Early life stressors
Food intolerance
Antibiotics
Enteric infection
,What are host factors contributing to IBS? - ✔✔- Altered pain perception
- Altered brain-gut interaction
- Dysbiosis (reduction in microbiota diversity)
- Increased intestinal permeability
- Increased gut mucosal immune activation
- Visceral hypersensitivity
What foods are often identified as triggers for symptoms in IBS? - ✔✔FODMAPs
- Fermentable Oligosaccharides
- Disaccharides
- Monosaccharides
- And Polyols
What are psychosocial factors affecting the pathophysiology of IBS? - ✔✔- Verbal, sexual, or physical
abuse
- Learned illness behaviors
- Hypervigilance, catastrophizing
What are common complaints by patients with IBS? - ✔✔- Loose/frequent stools
- Constipation
- Bloating
- Abdominal pain, discomfort, and cramping
- Symptoms triggered by eating
- Symptoms change over time
What are seven "concerning features" with IBS that may require further testing? - ✔✔- Symptom onset
after 50 y/o
- Sever or progressively worsening symptoms
- Unexplained weight loss
, - Nocturnal diarrhea
- Rectal bleeding or melena
- Unexplained iron deficiency
- Family history of GI diseases (colon cancer, IBD, celiac disease)
What is celiac disease? - ✔✔Immune-mediate disease in which foods containing the store protein,
gluten, lead to enteropathy in genetically susceptible individuals
What are useful inflammatory markers in diagnosis of celiac disease? - ✔✔- Immunoglobulin A (IgA)
tissue transglutimase
- Quantitative IgA level
If inflammatory markers are positive, what additional diagnostic measured are recommended? -
✔✔Upper endoscopy for biopsy
What is inflammatory bowel disease (IBD)? - ✔✔An umbrella term that is characterized by inflammation
of the mucosal layer
What are useful inflammatory markers in diagnosis of IBD? - ✔✔- Fecal calprotectin (fCal)
- Fecal lactoferrin (FL)
- C-Reactive Protein (CRP)
What is fecal calprotectin? What cells produce it? What is it a useful marker of? - ✔✔Is is a calcium
binding protein produced by neutrophils. It is a useful marker of neutrophil activity in the intestines
What is fCal highly resistant to? - ✔✔It is highly resistant to degradation by pancreatic and intestinal
secretions
What is fecal lactoferrin? What cells secrete it? - ✔✔It is an iron binding protein produced by active
neutrophils
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