PHAR2822 Lecture Notes - Lecture 2: Calcium Channel Blocker, Macrogol, Hemorrhoid
Document Summary
If initial treatment it not effective referral to a dietician for trial of a low fodmap diet. These are poorly absorbed fermentable carbohydrates that become substrates for bacterial metabolism in the bowel and can result in gas, diarrhoea or bloating. Osmotic laxative such as macrogol 3350, but take care as some ibs patients do not tolerate osmotic laxatives well ( particularly lactulose, sorbitol ) Peppermint oil capsules : 1-2 up to three times daily before food. Hyoscine: 20mg up to four times daily as needed. Mebeverine: 135mg ( 1 tab ) up to three times daily as needed. Cognitive behavioural therapy ( cbt) may be useful if symptoms are exacerbated by situations that cause anxiety. Probiotic: to address gut microbiota ( acute gastroenteritis can lead to development of ibs is some patients ). Improvement in gut microbiota with probiotics such as biffidobacterium may improve symptoms in some patients.
