{"id":323,"date":"2017-03-26T12:45:08","date_gmt":"2017-03-26T12:45:08","guid":{"rendered":"http:\/\/papergp.com\/index.php\/gi-and-renal\/ibs\/"},"modified":"2023-01-24T11:25:25","modified_gmt":"2023-01-24T11:25:25","slug":"ibs","status":"publish","type":"page","link":"https:\/\/papergp.com\/index.php\/gi\/ibs\/","title":{"rendered":"IBS"},"content":{"rendered":"<div class=\"content-box-blue\">\n<h4><strong>Differential diagnosis<\/strong><\/h4>\n<ul>\n<li>Malignancy (bowel, ovarian etc)<\/li>\n<li>Thyroid disease<\/li>\n<li>Coeliac disease<\/li>\n<li>IBD<\/li>\n<\/ul>\n<\/div>\n<p>&nbsp;\n<\/p><div class=\"content-box-blue\">\n<h4><strong>Data gathering<\/strong><\/h4>\n<ul>\n<li>Red flags &#8211; PR bleeding, weight loss, change in bowel habit, FH bowel or ovarian Ca, age &gt; 50<\/li>\n<li>Others &#8211; abdominal pain relieved by BO, mucus, bloating, association with food<\/li>\n<li>Examination &#8211; abdominal examination, PR<\/li>\n<\/ul>\n<\/div>\n<p>&nbsp;\n<\/p><div class=\"content-box-blue\">\n<h4><strong>Clinical management<\/strong><\/h4>\n<ul>\n<li>Investigations\n<ul>\n<li>Bloods &#8211; FBC, ESR, CRP, TFTs, TTG<\/li>\n<li>Stool &#8211; faecal calprotectin, MC&amp;S<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<ul>\n<li>Explanation\n<ul>\n<li>IBS is a condition that affects the function of the gut, it is thought that there may be some over-activity in some part of the bowel<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<ul>\n<li>Treatment\n<ul>\n<li>Fluid &#8211; 8 glasses of water\/day, reduce fizzy drinks\/caffeine\/alcohol<\/li>\n<li>Food &#8211; regular meals, limit fruit and high fibre diet<\/li>\n<li>Exercise<\/li>\n<li>Medications &#8211; see below<\/li>\n<li>CBT (if not improved in 12 months)<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<ul>\n<li>Follow-up \/ Safety-net \/ Refer\n<ul>\n<li>Consider dieticians &#8211; FODMAP diet<\/li>\n<li>Consider gastroenterology<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/div>\n<p>&nbsp;\n<\/p><div class=\"content-box-blue\">\n<h4>Medications<\/h4>\n<ul>\n<li>Antispasmodics\n<ul>\n<li>Mebeverine, Alverine, Peppermint oil<\/li>\n<\/ul>\n<\/li>\n<li>Antimuscarinics\n<ul>\n<li>Hyoscine Butylbromide (Buscopan)<\/li>\n<\/ul>\n<\/li>\n<li>Antimotility agents\n<ul>\n<li>Loperamide<\/li>\n<\/ul>\n<\/li>\n<li>Laxatives\n<ul>\n<li>Movicol (osmotic) or Fybogel (bulking) +- &nbsp;Senna (stimulant)<\/li>\n<\/ul>\n<\/li>\n<li>TCA\n<ul>\n<li>Amitriptyline 10-50mg ON<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/div>\n<p>&nbsp;<\/p>\n\n\n<h4 class=\"wp-block-heading\">Reference<\/h4>\n\n\n\n<ul class=\"wp-block-list\"><li><a href=\"https:\/\/gps.camdenccg.nhs.uk\/pathways\/irritable-bowel-syndrome\">https:\/\/gps.camdenccg.nhs.uk\/pathways\/irritable-bowel-syndrome<\/a><\/li><li>http:\/\/gp.barnetccg.nhs.uk\/downloads\/services\/pathways\/Gastroenterology\/Irritable-bowel-syndrome-July-2018-v7-3.pdf<\/li><\/ul>\n","protected":false},"excerpt":{"rendered":"<p>Differential diagnosis Malignancy (bowel, ovarian etc) Thyroid disease Coeliac disease IBD &nbsp; Data gathering Red flags &#8211; PR bleeding, weight loss, change in bowel habit, FH bowel or ovarian Ca, age &gt; 50 Others &#8211; abdominal pain relieved by BO, mucus, bloating, association with food Examination &#8211; abdominal examination, PR &nbsp; Clinical management Investigations Bloods &hellip; <a href=\"https:\/\/papergp.com\/index.php\/gi\/ibs\/\" class=\"more-link\">Continue reading <span class=\"screen-reader-text\">IBS<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"parent":315,"menu_order":68,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-323","page","type-page","status-publish","hentry"],"jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/pages\/323","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/comments?post=323"}],"version-history":[{"count":8,"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/pages\/323\/revisions"}],"predecessor-version":[{"id":2404,"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/pages\/323\/revisions\/2404"}],"up":[{"embeddable":true,"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/pages\/315"}],"wp:attachment":[{"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/media?parent=323"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}