UPDATES ON MANAGEMENT OF IRRITABLE BOWEL SYNDROME

More documents

Recommendations

Info

Pain modulatorsAntidepressant Ach 5HT Histamine Dose /effect uptake effect dayTCAsAmitriptyline ++++ +++ ++++ 25‐150mgDoxepin ++ +++ ++++ 25‐150mgDesipramine + +++ + 25‐150mgNortriptyline ++ + ++ 25‐150mgSSRIsCitalopram nil ++++ nil 20mgFluoxetine nil ++++ nil 20mgParoxetine nil ++++ nil 50mgSertraline nil ++++ nil 150mg
Psychosocial TherapiesCBT• Cognitive : to change underlying maladaptivethinking/perception of symptoms• Behavior : to modify dysfunctional behaviors• Best studied psychological therapy• NNT : 2• GOR : 1BHow does cognitive behavior therapy for irritable bowel syndrome work? A mediationalanalysis of a randomized clinical trialLackner JM; Jaccard J; Krasner SS; Katz LA; Gudleski GD; Blanchard EBGastroenterology. 2007 Aug;133(2):433‐44. Epub 2007 May 21.
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 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: Anti‐depressantsSSRI• Less publ
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
Page 77 and 78: CASE SCENARIOIS IT REALLY IBS?
Page 79 and 80: Ms.Cheung• Is it IBS?• Given ch
Page 81 and 82: Mr.Leung• Is it IBS?• CT abdome
Page 83 and 84: Points to note• Red flags for a c
show all

UPDATES ON MANAGEMENT OF IRRITABLE BOWEL SYNDROME

You also want an ePaper? Increase the reach of your titles

Delete template?

Save as template?