UPDATES ON MANAGEMENT OF IRRITABLE BOWEL SYNDROME
UPDATES ON MANAGEMENT OF IRRITABLE BOWEL SYNDROME UPDATES ON MANAGEMENT OF IRRITABLE BOWEL SYNDROME
Pathophysiology• Poorly understood, likely multifactorial• Proposed mechanismsGenetic predispositionAltered motilityVisceral afferent hypersensitivity& brain‐gut interactionsMucosal inflammationAlteration in fecal microfloraEmotional stressConflicting results
Genetic predisposition• Similar symptoms tends to run in family• Differences in inherited patterns of serotoninprocessing at the neuronal level• Study suggested that IBS is more common inpatients who have a first degree relatives whohas IBS symptoms• Another study showed that IBS is more commonin monozygotic than dizygotic twins, butpresence of a parent who had IBS was even morepredicitve for subsequent development of IBS
- 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 and 14: DIAGNOSIS
- Page 15 and 16: Manning criteria• > 3 of the foll
- 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: PATHOPHYSIOLOGY
- 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)
- Page 65: Tegaserod• Only 5HT4 Receptor ago
- Page 69 and 70: Lubiprostone• Selective C‐2 chl
- Page 71 and 72: Summary of Treatment forIBS‐assoc
- Page 73 and 74: Alternative Therapies• Peppermint
Pathophysiology• Poorly understood, likely multifactorial• Proposed mechanismsGenetic predispositionAltered motilityVisceral afferent hypersensitivity& brain‐gut interactionsMucosal inflammationAlteration in fecal microfloraEmotional stressConflicting results
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