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Old 05-19-2013
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Default Gastroenterology q8

Which of the following patients requires no further testing before making the diagnosis of irritable bowel syndrome and initiating treatment?
A. A 76-year-old woman with 6 months of intermittent crampy abdominal pain that is worse with stress and associated with bloating and diarrhea.
B. A 25-year-old woman with 6 months of abdominal pain, bloating, and diarrhea that has worsened stead-ily and now awakes her from sleep at night to move her bowels.
C. A 30-year-old man with 6 months of lower abdomi-nal crampy pain relieved with bowel movements, usually loose. Symptoms are worse during the day-time at work and better on the weekend. Weight loss is not present.
D. A 19-year-old female college student with 2 months of diarrhea and worsening abdominal pain with occasional blood in her stool.
E. A 27-year-old woman with 6 months of intermittent abdominal pain, bloating, and diarrhea without asso-ciated weight loss. Crampy pain and diarrhea persist after a 48-hour fast.
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Old 05-19-2013
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Originally Posted by cingulate.gyrus View Post
Which of the following patients requires no further testing before making the diagnosis of irritable bowel syndrome and initiating treatment?
A. A 76-year-old woman with 6 months of intermittent crampy abdominal pain that is worse with stress and associated with bloating and diarrhea.
B. A 25-year-old woman with 6 months of abdominal pain, bloating, and diarrhea that has worsened stead-ily and now awakes her from sleep at night to move her bowels.
C. A 30-year-old man with 6 months of lower abdomi-nal crampy pain relieved with bowel movements, usually loose. Symptoms are worse during the day-time at work and better on the weekend. Weight loss is not present.
D. A 19-year-old female college student with 2 months of diarrhea and worsening abdominal pain with occasional blood in her stool.
E. A 27-year-old woman with 6 months of intermittent abdominal pain, bloating, and diarrhea without asso-ciated weight loss. Crampy pain and diarrhea persist after a 48-hour fast.
This description is basically all the criteria for IBS
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Old 05-20-2013
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This description is basically all the criteria for IBS
The answer is C
Irritable bowel syndrome is characterized by the follow-ing: recurrence of lower abdominal pain with altered bowel habits over a period of time without progressive deterioration, onset of symptoms during periods of stress or emo-tional upset, absence of other systemic symptoms such as fever and weight loss, and small-volume stool without evidence of blood. Warning signs that the symptoms may be due to something other than irritable bowel syndrome include presentation for the first time in old age, progressive course from the time of onset, persistent diarrhea after a 48-hour fast, and presence of nocturnal diarrhea or steatorrheal stools. Each patient, except for patient C, has “warning” symptoms that should prompt further evaluation.


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