Irritable Bowel Syndrome (IBS) - Pathophysiology, Diagnosis ...
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Description

Irritable Bowel Syndrome (IBS) - Pathophysiology, Diagnosis and Management Algorithm

Risk factors: Previous acute enteric infection, Female sex, Younger age, Other functional somatic syndromes (e.g. fibromyalgia, chronic fatigue)

Risk factors affecting symptom severity:

 - Less severe, more common: Food, Acute gastrointestinal infection, Mucosal inflammation, Abdominal or pelvic surgery, Menses

 - More severe, less common: Life stress, Somatisation, Anxiety or depression, Poor coping skills, Poor social support, Maladaptive cognitions, Abuse

Diarrhea:

 - 1st Line: Loperamide, Antispasmodics

 - 2nd Line: Tricyclic antidepressants, 5-HT3 antagonists, Rifaximin, Eluxadoline

Constipation:

 - 1st Line: Laxatives, Soluble fibre

 - 2nd Line: Lubiprostone, Linaclotide, Plecanatide, Tenapanor, 5-HT4 agonists

Pain:

 - 1st Line: Antispasmodics, Peppermint oil

 - 2nd Line: Tricyclic antidepressants, Pregabalin



#IBS #Irritable #Bowel #Syndrome #Pathophysiology #Diagnosis #Management #Algorithm #gastroenterology
Contributed by

Dr. Michael Chew
@mchew85
GrepMed Gastroenterology-Hepatology Editor, Academic Hospitalist UC Davis Medical Center Internal Medicine, Yale Gastroenterology Fellow '22
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