Page 256 - 2021 IDMT Digital

IRRITABLE BOWEL SYNDROME (IBS)
Introduction:
• ,%6 FKURQLF IXQFWLRQDO QR DEQRUPDO ILQGLQJV GLVRUGHU FKDUDFWHUL]HG E\ recurrent
abdominal pain RU GLVFRPIRUW ZLWK DOWHUQDWLRQV LQ ERZHO KDELWV
• 3DLQ ZLWK WZR RXW RI WKUHH RI WKH IROORZLQJ IHDWXUHV
o 5HOLHYHG ZLWK GHIHFDWLRQ
o 2QVHW DVVRFLDWHG ZLWK D FKDQJH LQ IUHTXHQF\ RI VWRRO
o 2QVHW DVVRFLDWHG ZLWK D FKDQJH LQ IRUP RI VWRRO
• 0RUH FRPPRQ LQ ZRPHQ
Subjective:
• 6LJQV DQG 6\PSWRPV
o $EGRPLQDO SDLQ LQWHUPLWWHQW FUDPS\ ORZHU DEGRPHQ
o ,%6 ZLWK FRQVWLSDWLRQ LQIUHTXHQW ERZHO PRYHPHQWV VWUDLQLQJ KDUG OXPS\ VWRROV
o ,%6 ZLWK GLDUUKHD ORRVH RU ZDWHU\ VWRROV ! VWRROV SHU GD\ XUJHQF\ IHFDO
LQFRQWLQHQFH
o ,%6 ZLWK PL[HG V\PSWRPV DOVR SUHVHQW
o $OVR PD\ KDYH IHHOLQJ RI LQFRPSOHWH HYDFXDWLRQ SDVVDJH RI PXFXV
EORDWLQJ IHHOLQJ RI GLVWHQWLRQ
o 3DWLHQWV PD\ KDYH RWKHU VRPDWLF RU SV\FKRORJLFDO FRPSODLQWV VXFK DV
G\VSHSVLD FKHVW SDLQ KHDGDFKHV IDWLJXH P\DOJLDV DQ[LHW\ GHSUHVVLRQ
• )RFXVHG +LVWRU\
o /LIH VWUHVVRUV
o 0HQWDO KHDOWK KLVWRU\
Objective:
• 3K\VLFDO ([DP
o 8VXDOO\ QRUPDO
o 0D\ KDYH DEGRPLQDO WHQGHUQHVV LQ ORZHU DEGRPHQ WKDW LV QRW SURQRXQFHG
• 7RROV
o )XUWKHU GLDJQRVWLF WHVWLQJ XVXDOO\ XQQHFHVVDU\
Assessment:
• 'LIIHUHQWLDO
o 3V\FKLDWULF GLVRUGHUV e.g., GHSUHVVLRQ SDQLF GLVRUGHU DQ[LHW\ FDUHIXO KLVWRU\
DQG LQWHUYLHZ
o ,%' VHYHUH DEGRPLQDO SDLQ ZLWK EORRG\ GLDUUKHD PD\ KDYH SRVLWLYH IDPLO\
KLVWRU\
o 9LUDO JDVWURHQWHULWLV GLDUUKHD FRPPRQ EXW RQVHW RI YRPLWLQJ EHIRUH SDLQ PDNHV
DSSHQGLFLWLV OHVV OLNHO\ XVXDOO\ PLOG DQG VHOI OLPLWLQJ SDiQ LV XVXDOO\ ELODWHUDO
o %DFWHULDO JDVWURHQWHULWLV GLDUUKHD ZLWK PRUH VHYHUH V\PSWRPV PD\ KDYH D IHYHU
DQG EORRG\ GLDUUKHD
o *DVWULWLV LQIODPPDWLRQ RI WKH JDVWULF PXFRVD

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