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Liver & GIT

3 out of 4

A girl comes with recent change in bowel habit with mucus in stool, no blood. Increase with menstruation and stress (AIPG 2010)

B Ulcerative colitis

C Giardiasis
D Amebiasis

Ans. A IBS

a. Irritable bowel syndrome (IBS) is a functional bowel disorder in which abdominal pain is associated with defecation or a change in bowel habit.

b. There is no structural pathology in the intestine.

Lubiprostone: It activates a specific chloride channel (CIC-2) on cells lining the gut, therapy for chronic constipation.

Diagnostic criteria for IBS (Rome II criteria, 2006)

Recurrent abdominal pain or discomfort at least 3 days per month in the last 3 month associated with two or more of the following

1. Improvement with defecation

2. Onset associated with a change in frequency of stool

3. Onset associated with change in form (appearance) of stool

i. Pre requisite for diagnosis of IBS – Abdominal pain

ii. Most consistence feature of IBS – Altered bowel habits

Note: Features are against the diagnosis of IBS. 1. Presence of fever 2. GI bleed 3. Marked weight loss.

Management: 1. Psycho therapy 2. Amitriptyline 3.5-HT4 agonists.