UPDATES ON MANAGEMENT OF IRRITABLE BOWEL SYNDROME
UPDATES ON MANAGEMENT OF IRRITABLE BOWEL SYNDROME UPDATES ON MANAGEMENT OF IRRITABLE BOWEL SYNDROME
Diagnosis• No clear diagnostic biomarkers• ? by exclusion• Symptoms based criteria x high likelihood of IBS Manning (1978 )• conflicting data regarding predictive ability Rome I (1990 ), Rome II (1999) , Rome III (2007)• revised by international working team for standardization of diagnosis
Manning criteria• > 3 of the following features:Onset of pain linked to more frequent bowel movementsLooser stools associated with onset of painPain relieved by passage of stoolNoticeable abdominal bloatingSensation of incomplete evacuation more than 25% of the timeDiarrhea with mucus more than 25% of the time• Pooled sensitivity : 78% Specificity 72%
- Page 1 and 2: UPDATES ON MANAGEMENT OFIRRITABLE B
- Page 3 and 4: Prevalence• Common GI condition
- Page 5 and 6: Prevalence in HK• Hong Kong 1000
- Page 7 and 8: Impact• Direct cost Prescription
- Page 9 and 10: Clinical manifestations• Othersbe
- Page 13: DIAGNOSIS
- Page 17 and 18: Symptom‐based diagnosticcriteriaL
- Page 19 and 20: How alarming ?SensitivitySpecificit
- Page 21 and 22: Diagnosis• Consensus statement is
- Page 23 and 24: Emerging specific Investigations•
- Page 25 and 26: PATHOPHYSIOLOGY
- Page 27 and 28: Genetic predisposition• Similar s
- Page 29 and 30: Visceral Hypersensitivity andBrain
- Page 31 and 32: Small Intestine BacterialOvergrowth
- Page 33 and 34: Psychological Dysfunction• Not et
- Page 35 and 36: General PrincipleNon pharmacologica
- Page 37: Compare components of placebo effec
- Page 40 and 41: Outcomes at six week follow-upKaptc
- Page 42 and 43: Patient Education• Explain about
- Page 44: Psychosocial Therapies• Interpers
- Page 48 and 49: Pharmacological treatment• IBS wi
- Page 51 and 52: NNT=5(95% CI 4‐9 )
- Page 53 and 54: Anti‐depressantsSSRI• Less publ
- Page 55 and 56: Psychosocial TherapiesCBT• Cognit
- Page 57 and 58: IBS WITH DIARRHEA
- Page 59 and 60: Alosetron• 1 st IBS specific medi
- Page 61 and 62: Summary of Treatment forIBS‐assoc
- Page 63 and 64: FiberNNT: 11(95%CI ,5‐100)
Diagnosis• No clear diagnostic biomarkers• ? by exclusion• Symptoms based criteria x high likelihood of IBS Manning (1978 )• conflicting data regarding predictive ability Rome I (1990 ), Rome II (1999) , Rome III (2007)• revised by international working team for standardization of diagnosis
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