Irritable Bowel Syndrome - CRASH! Medical Review Series

(Disclaimer: The medical information contained herein is intended for physician medical licensing exam review purposes only, and are not intended for diagnosis of any illness. If you think you may be suffering from any medical condition, you should consult your physician or seek immediate medical attention.)

[geoffreykibuga]

An excellent and clinically relevant presentation

[woloabel]

Friday, October 28, 2022. Gastroenterology: Irritable Bowel Syndrome (IBS) is a Chronic (Symptoms have persisted > 3 Months) Idiopathic Gastrointestinal Disorder (Neurologic/Psychiatric Mechanism is Possible) manifested as Abdominal Pain with Amelioration of Symptoms by Bowel Movement, otherwise a Disorder of Peristalsis. Women have a Predominance to IBS (Sexual Assault Correlation/Association due to Preponderance in Incidence). IBS is a Diagnosis of Exclusion (Extensive Investigation onto the Disease without any Aetiologic Explanation). SSx: 1) Diarrhea, and/or 2) Constipation. Hx is marked by an Unamenable Chronic Diarrhea (Refractory and Unexplainable Diarrhea) in a Female who has a profile of Sexual Assault/Abuse: 1) No Steatorrhea, 2) No Hematochezia, 3) No Weight Loss, or 4) Constitutional Symptoms (Fever, Malaise, Weight Loss etc.). This profile is known as the Roma Criteria. Dx: For the IBS Diagnosis to apply, there must have been a thoroughly investigated disease process for possible Aetiologic Mechanisms of Diarrhea and Constipation (Normal Stool Studies, Normal Colonoscopy if Performed, Lactose Intolerance Negative and/or No Correlation with Diary). Tx is particular to the Subject and Symptom-Based because IBS has Multiple Elements of Pathology in the Mechanism of Disease (Gastrointestinal, Pain, Neurologic and/or Psychiatric): 1) High-Fiber diet is otherwise the only indication for all IBS Subjects at a rate of 25-30 Grams Per diem (US Epidemiology has a 90% Deficiency in Fiber Intake); 2) Interdiction of Caffeine, Spasmogenic, and Sugar Substitutes (Diarrheagenic); 3) Diarrhea via Anti-Diarrhea Agents: 1) Loperamide, or 2) Diphenoxylate and 5-HT3/Serotonin Antagonists, Alosetron (Targeting Serotonin Receptors Specific to the Intestinal Mucosa) because Serotonin has a natural Neurohormonal Effect of Gastrointestinal Motility Promotion, and Serotonin Therapy has an Adverse Effect of Diarrhea as in Selective Serotonin Reuptake Inhibitors (SSRIs) Treatment; 4) Constipation with 5-HT4 Agonist, Tegaserod; and Bulking Laxatives, Methylcellulose or Psyllium; 5) For Pain there is Anti-spasmodics, Dicyclomine or Hyoscyamine (Short-Term to Avoid Aggravation of Pain); and 6) Tricyclic Antidepressants (TCAs), a common Secondary use for Chronic Neuropathic Pain: 1) Imipramine, a Non-Selective Reuptake Inhibitor (Norepinephrine) or Amitriptyline is a Serotonin/Norepinephrine Reuptake Inhibition (SNRI). Goodness, IBS certainly is a cumbersome disease, as is the diagnosis. MD Paul Bolin, Die Weib muss immer die Ruhe haben aber Der Mann immer die Weib haben auch. Heil!

[GodsMan]

There is a significant percentage of patients who do much worse on a high fiber diet. Also, the distinction between soluble and insoluble fiber should be considered and discussed here.

[philippadrake]

A high fibre diet doesn't help everyone with IBS. If you have IBS D, or A, high fibre can make symptoms worse. One size doesn't fit all. I started with IBS C then I got IBS A. When I had very loose stools, it was more helpful to reduce my fibre intake! Once I got constipated again, I would increase fibre.

[joyceforeit]

I have no pain and was diagnosed with ibs

[maryannepatriciaclark]

Crohn's disease !!! Are any medications that helps this horrible chronic disease.
I have this horrible disease. I was a ginney pig a d went through horrible experiments at the hands of several doctors after my intestines exploded and my stool spread throughout my stomach. Can you shed any cure or pills that can help me PLEASE?

[dr.tilahun]

The cinfluence of superior mesenteric vain and spleenic vain forms Portal Vain not hepatic vain and it's hepatic vain that drains into IV.

[KishoreKumar-zpyr]

Stop coffee and tea, avoid white fenugreek sprouts before breakfast, hartika(kadukkai podi in Tamil) powder in hot water before Do some simple This cures 100% without any medicine you can come good, take 1 cup of yogurt without sugar

[lauradean]

You're missing some important idiosyncrasies of IBS. High fiber for all types? Never associated with lactose?? Look at the Rome IV interactive clinical tool.