Gastrointestinal System Disorders Q 130 - Gyan Darpan : Learning Portal
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Thursday 14 April 2022

Gastrointestinal System Disorders Q 130

Which of the following medications is most effective for treating the pain associated with irritable bowel disease?
    A. Acetaminophen
    B. Opiates
    C. Steroids
    D. Stool softeners

Correct Answer: C. Steroids

The pain with irritable bowel disease is caused by inflammation, which steroids can reduce. If a patient has concerns about abdominal pain, bloating, cramping, and changes in bowel habits, a visit to a primary care physician is advised. If IBS is diagnosed, a gastroenterology consultation will be needed as they can guide management and treatment.

Option A: Acetaminophen has little effect on the pain. Prednisone is a steroid with anti-inflammatory effects. It is used to treat inflammation in ulcerative colitis and Crohn’s disease. However, steroids do not prevent symptoms from returning and have many side effects. Sometimes, it is necessary to use steroids to treat IBD, especially during “flares.”
Option B: Opiate narcotics won’t treat its underlying cause. In inflammatory bowel disease (IBD), corticosteroids are the mainstay of “rescue” therapy for patients who are experiencing a disease flare. Corticosteroids often lead to rapid resolution of IBD symptoms, which aligns with patient preferences for treatment. However, this may lead to inappropriate use of these medications for maintenance when other treatment options may be better in the longer term.
Option D: Stool softeners aren’t necessary. For constipation, fiber supplements and laxatives can be helpful whereas, in those with diarrhea, medications such as loperamide or probiotics can be helpful. Escalation of therapy to corticosteroid-sparing maintenance therapy such as immunomodulators or biological agents can improve disease outcomes and avoid the complications of prolonged steroid use.

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