IBS

• Dicyclomine hydrochloride (Bentyl)
• Hyoscyamine sulfate (Levsin)

abdominal discomfort or pain

• abdominal discomfort or pain that is relieved after a bowel movement (Hallmark Sx)
• Alternating periods of diarrhea and constipation
• Change in stool frequency
• Passing Mucus from rectum
• Bloating

Irritable bowel disease.

sex life

12 weeks for the last 12 months.  Does not have to be consecutive 12 weeks.

• 1. Relieved after BM
• 2. Onset associated with change in frequency of stool
• 3. Onset associate with change in form of stool.

decrease motility, relax smooth muscle tone in GI tract, decrease secretions

• Tegaserod (Zelnorm)- constipation main sx
• Alosetron (Lotronex)- severe IBS and have not responded to other tx  (diarrhea is main sx)

Diet with adequate fiber

Fluid and fiber have to be increased.

antispasmodic

bulk forming laxatives

• lower doses
• may have adverse affects such as agitation, confusion, excitement, or delusions.
• At risk for falls from OD

• refrain from activities that require mental alertness
• stay out of hot and humid environments
• take 30-60 min before meal

20-40 mg qid ac and hs

Geriatrics- 10mg and slowly increase

• potential serious GI adverse reactions
• -ischemic collitis
• -serious constipation

Discontinue immediately if patient develops colitis (even if GI specialist started)

• gastroparesis
• severe GERD
• prevention of chemo n/v

stimulates upper GI tract

Accelerates gastric emptying.

• NO ETOH
• Do not operate heavy machinery
• Notify provider of any EP symptoms (tardive dyskinesia)

• sulfasalazine
• mesalamine

used to dissolve gallstones when patients refuse surgical intervention or are high risk surgery candidates.

Can be used prophylactically as gallstone prevention.