What is the first line pharmacologic therapy for IBS-D (diarrhea)?

All of the following describe IBS, EXCEPT one that describes IBD. (choose 1 that describes IBD)

All of the following describe IBD, EXCEPT one that describes IBS. (choose 1 that describes IBS)

Abd pain, bloating, change in bowel habits

Rectal bleeding, diarrhea, urgency/fear of incontinence

Abd pain, weight loss, diarrhea

What type of patient is most often affected by IBS? (choose 2)

Which of the following is NOT part of the pathophysiology of IBS?

Pt presents with abd pain and bowel habit changes. They note rapid alternating between diarrhea and constipation. Which of the following symptoms would you NOT expect to see with this disease?

All of the following are non-GI symptoms or concurrent conditions that can be seen with IBS, but which is common in children?

Which of the following is NOT a "red flag" in patients presenting with IBS-like symptoms?

What criteria are commonly used to diagnose IBS? (choose 2)

Most prevalent severity of IBS (70%) with high correlations to gut physiology that can be managed by primary care.

Second most prevalent severity of IBS (25%) with medium correlations to gut physiology, symptoms more frequently, some psychosocial difficulties and healthcare issues. Should be managed by a specialist.

Least prevalent severity of IBS (5%) with low correlations to gut physiology, constant symptoms, the most psychosocial difficulties and healthcare issues. Should be referred out.

Which of the following is NOT a dietary modification recommended for IBS?

IBS dietary recommendation is low FODMAP diet. What does FODMAP stand for?

Which of the following is NOT a possible treatment for IBS related diarrhea?

Which of the following is NOT a possible treatment for IBS related constipation?

Which of the following is NOT a possible treatment for IBS related abd pain?

Which of the following is NOT a possible treatment for IBS related gas and bloating?

What type of IBS do the following treat? Dietary fiber, psyllium, PEG, Linaclotide, Lubiprostone, Tegaserod, Dicyclomine, Hyoscyamine.

What type of IBS do the following treat? Loperamide, Alosetron, Dicyclomine, Hyoscyamine, Eluxadoline, Colestipol, Rifaximin.

IBS-C treatment with MOA of producing bulkier and more easily passed stools. (choose 2)

IBS-C treatment with MOA of osmotic laxative causing water retention in stool, increases stool frequency.

IBS-C treatment with MOA of guanylate cyclase-C agonist. Agonist of cell surface receptors to increase cGMP and increase chloride and bicarbonate secretion into the intestinal lumen. Decreases transit time and visceral pain.

IBS-C treatment with MOA of chloride channel activator that acts on apical membrane to increase intestinal fluid secretion. Improves fecal transit, bypasses antisecretory effects of opiates, which suppresses secretomotor neuron excitability.

IBS-C treatment with MOA of 5-HT4 agonist. Reduces abd pain, constipation, and dyspepsia.

IBS-C and IBS-D treatment with MOA of antispasmodics that blocks action of acetylcholine at the PNS sites in smooth muscle; secretory glands of the CNS. (choose 2)

Which one of the following is NOT considered 1st line for IBS-C treatment?

IBS-C treatment approved for emergency treatment ONLY.

IBS-C treatment approved for women 18+ with persistent constipation.

IBS-C pharm treatment for diagnosis of mild, less frequent symptoms. (choose 2)

What is NOT part of the treatment of IBS-C for diagnosis of moderate, persistent? This is on top of dietary fiber, psyllium (bulk forming).

What is the treatment of IBS-C for diagnosis of severe?

IBS-D treatment with MOA of slowing intestinal motility, enhance water & electrolyte absorption, strengthens rectal sphincter tone.

IBS-D treatment with MOA of 5-HT3 antagonist - blocks serotonin bindign to receptor.

IBS-D treatment with MOA of mu-opioid agonist and delta-opioid antagonist. Acts locally to reduce abd pain & diarrhea.

IBS-D treatment with MOA of bile acid sequestrant that binds bile salts and cholesterol in the GI tract to prevent absorption.

IBS-D treatment with MOA of antimicrobial that improves abd pain, stool consistency, and bloating.

Treatment of mild, less frequent IBS-D.

Treatment of moderate, persistent IBS-D. (choose 2)

Treatment of severe IBS-D. (choose 3)

Which IBS-D treatment is NOT considered 1st line?

IBS-D treatment that is CI in children less than 2 d/t serious cardiac adverse reactions (Torsades de Pointes, sudden death) & risk respiratory depression.

IBS-D treatment that is used for short term relief.

IBS-D treatment that is CI in pts w/ hx biliary DO, pancreatitis, severe liver impairement or heavy alcohol use.

IBS-D treatment used for episodic management of urgent diarrhea.

IBS-D treatment with restricted use - only women w/ diarrhea-predominant IBS who have failed other treatments.

IBS-C treatment with CI of hx ischemic colitis, intestinal ischemia, bowel obstruction or adhesions, symptomatic gallbladder disease, and suspected Sphincter of Oddi dysfunction. Warning of cardiovascular ischemic events, including major adverse cardiovascular events.

Treatment of abd pain related to IBS with MOA of anticholindergic properties that slow intestinal transit.