GIq1 - meshi

[ArchivalUser]

A 24-year-old white female presents to the office with a 6-month history of abdominal pain. A physical examination, including pelvic and rectal examinations, is normal. Which one of the following would indicate a need for further evaluation?

A. Relief of symptoms with defecation
B. Changes in stool consistency from loose and watery to constipation
C. Passage of mucus with bowel movements
D. Abdominal bloating
E. Worsening of symptoms at night

[ArchivalUser]

eee

[ArchivalUser]

e. not functional dyspepsia or IBS

[ArchivalUser]

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[ArchivalUser]

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[ArchivalUser]

E
Irritable bowel syndrome (IBS) is a benign, chronic symptom complex of altered bowel habits and abdominal pain. It is the most common functional disorder of the gastrointestinal tract. The presence of nocturnal symptoms is a red flag which should alert the physician to an alternate diagnosis and may require further evaluation. The other symptoms listed are Rome I and II criteria for diagnosing irritable bowel syndrome. Ref: Viera AJ, Hoag S, Shaughnessy J: Management of irritable bowel syndrome. Am Fam Physician 2002;66(10):1867-1874, 1880.