Irritable Bowel Syndrome: Presentation and Treatment

by Carlo Raj, MD

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    00:01 Here we have irritable bowel syndrome. IBS.

    00:04 Students, when taking an exam and trying to differentiate irritable bowel syndrome from another term that often has the same acronym, shares as one, and many time during studying, people just stick to that acronym and forget to what it actually stands for, irritable bowel syndrome, do not confuse this with inflammatory bowel disease.

    00:27 So irritable bowel syndrome, in terms of the pathogenesis is, well, it is interesting, mysterious, idiopathic, more or less, psychological.

    00:38 Irritable bowel syndrome mean exactly that is that the bowel system is being irritated to the point where sometimes your patient might have times of diarrhea, other times it might be times of constipation.

    00:52 Completely different than that of inflammatory bowel disease.

    00:58 So what is irritable bowel syndrome? Chronic abdominal pain, altered bowel habits, I´ll pause here for one second.

    01:08 Your patient may present with constipation, your patient may present with diarrhea, in the absence of all structural disorders.

    01:18 Always a diagnosis, always a diagnosis of exclusion, bowel habits either combination of alternating constipation/diarrhea or predominantly one or the others.

    01:31 You just, you never know what you are going to get.

    01:33 The abdominal pain is relieved after bowel is moving. So what is exactly is causing this? Well, there might be psychological issues and by that, we mean stress.

    01:44 Management: Well, if there is constipation, high fiber diet.

    01:53 It all depends as to how your patient is presenting. Remember? Antispasmodics, if it's the abdominal pains, anti-motility agents if its diarrhea.

    02:05 Anti depressants, remember I told you, psychologic issues, that there might be stress involved here which then causes altered bowel habits.

    02:16 Irritable bowel syndrome.

    About the Lecture

    The lecture Irritable Bowel Syndrome: Presentation and Treatment by Carlo Raj, MD is from the course Small and Large Intestine Diseases: Basic Principles with Carlo Raj.

    Included Quiz Questions

    1. Chronic abdominal pain relieved by bowel movements
    2. Increased mucus in the stool
    3. Weight loss and fever
    4. Persistent diarrhea only
    5. Severe abdominal cramping without relief
    1. Blood in stool
    2. Diarrhea
    3. Constipation
    4. Frequent bowel reflexes
    5. Abdominal pain
    1. Anti-depressants
    2. Azathioprine
    3. Sulfasalazine
    4. Increased fiber intake
    5. Antibiotics
    1. IBS is primarily diagnosed with colonoscopy.
    2. The patient can present with alternating episodes of constipation and diarrhea.
    3. Antimotility agents are helpful in treating a diarrheal type of IBS.
    4. Psychological stress is a risk factor for IBS.
    5. IBS is typically a diagnosis of exclusion.

    Author of lecture Irritable Bowel Syndrome: Presentation and Treatment

     Carlo Raj, MD

    Carlo Raj, MD

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    Rome Criteria III
    By Hamed S. on 09. March 2017 for Irritable Bowel Syndrome: Presentation and Treatment

    It would have been useful to go over the Rome III criteria to have an appreciation of the diagnostic criteria. Moreover, it would be extremely beneficial to cover the red flags