IRRITABLE BOWEL SYNDROME

IRRITABLE BOWEL SYNDROME

Definition:-

Irritable bowel syndrome is benign, chronic symptom complex of altered bowel habits and abdominal pain,it is relapsing and remitting condition.

High risk group:-
(Women more than men (3:1.
Lower socioeconomic class.

Person younger than 50 years.

Red Flags:-

-Rectal bleeding

-Weight loss

Iron deficiency anemia

New Or recent onset in patient older than 50 years

Persistent  diarrhea or severe constipation

Palpable mass or rectal mass

7-family hisotry of colorectal cancer,inflammatory bowel disease

Clinical Presentations:-

Abdominal pain for at least 3 months

Altered stool ferquency and consistency

Pain relived by defecation

Feeling of incomplete evacuation

Passing mucus per rectum

Abdominal fullness,bloating or swelling

Associated Symptoms:-

-Depression

-Anxiety

-Dyspareunia

-Stressful

-poorer general health and less educated

General examination:-(no physical findings)

Differentional diagnosis:-

-Colon cancer

-Hyperthyrodism and hypothyrodism

-Malabsorption syndrome

-Chronic constipation

-Celiac disease

Treatment:-

-Non-pharmacological therapy:-

     a-Dietary advise

-pharmacological therapy:-

  a-metoclopromide for nausea

  b-Simethicone for abdominal gas or floating

  c-conistipation Predominant

             -Increase Fibrate         

             -laxative         

             -Lactulose         

  d-Pain Predominant:-

              -Mebeverine       

              -Hyosine