Labs & Diagnosis
This fecal marker is used to differentiate IBS from IBD. A value < 50 ug/g (like Karla’s) indicates a lack of intestinal inflammation.
What is Fecal Calprotectin?
This stimulant laxative caused Karla’s worsening cramping and diarrhea because it irritates the myenteric plexus, triggering her visceral hypersensitivity.
What is Bisacodyl?
The "tapioca-like nodules" found along Karla’s upper 2/3 of the anterior IT band represent this diagnostic reflex.
What are Anterior Chapman Points for the Colon?
This diet is considered the gold standard for reducing flatulence by limiting fermentable, poorly absorbed short-chain carbohydrates.
What is the Low FODMAP diet?
This set of clinical criteria requires recurrent abdominal pain at least 1 day/week for 3 months, associated with defecation or changes in stool frequency/form.
What are the Rome IV Criteria?
This M3 antagonist is used to provide relief from persistent abdominal cramps by relaxing GI smooth muscle.
What is Dicyclomine?
This sympathetic spinal level range correlates with Karla’s thoracolumbar paraspinal hypertonicity.
What is T10–L2?
This poly-botanical supplement contains peppermint and licorice and is used for its carminative and anti-inflammatory effects.
What is STW 5 (Iberogast)?
Karla’s history of "food poisoning" in college puts her at risk for this specific subtype of IBS.
What is Post-Infectious IBS?
This medication activates ClC-2 channels to increase chloride-rich fluid secretion into the gut.
What is Lubiprostone?
parasympathetic supply to the proximal 2/3 of Karla’s colon
What is the Vagus Nerve?
This type of fiber (e.g., Psyllium) is preferred for IBS because it forms a gel, but it requires high water intake to avoid worsening constipation.
What is Soluble Fiber?
This endocrine disorder is a key differential diagnosis for constipation and must be ruled out.
What is Hypothyroidism?
This GC-C agonist increases cGMP, which both stimulates secretion via CFTR and desensitizes pain-sensing nerves in the gut.
What is Linaclotide?
In the Metabolic-Energy Model, this physical exam finding in Karla’s LLQ suggested restricted venous and lymphatic drainage of the bowel.
What is Mesenteric Drag?
Karla finds this diet difficult to follow specifically because she travels for work and lacks control over ingredients in restaurant meals.
What is the Low FODMAP or Comprehensive Elimination Diet?
These four clinical "Red Flags" (not present in Karla) would mandate an immediate colonoscopy rather than an IBS diagnosis.
What are nocturnal diarrhea, weight loss, gross hematochezia (blood in stool), and family history of GI cancer/IBD?
To be effective in managing IBS, probiotics should contain at least this many CFUs and possess this specific coating to survive HCl in the stomach.
What is 10 billion CFUs and Enteric Coating?
This osteopathic model examines how Karla’s history of sexual trauma and work stress contributes to her gut dysfunction via the HPA axis.
What is the Behavioral (Psychosocial) Model?
This lifestyle change helps move the "anorectal angle" into a straighter position to facilitate easier defecation.
What is Squatting (using a stool/Squatty Potty)?