Rome III Criteria for Diagnosis of Irritable Bowel Disease include all the following except

After a careful history and physical and a cost-effective workup, you have diagnosed a 24-year old woman patient with irritable bowel syndrome. What other condition would you reasonably expect to find in this patient?

A 29-year-old woman presented with abdominal discomfort. She feels abdominal discomfort on most days of the week and the pain varies in location and intensity. She notes constipation as well as diarrhea, but diarrhea predominates. Compared to 6 months ago, she has more bloating and flatulence than she has had before. She identifies eating and stress as aggravating factors, and her pain is relieved by defecation. You suspect irritable bowel syndrome. Laboratory data include WBC count 8000/μL, Hb 10 g/dl, platelets 210,000/μL, and erythrocyte sedimentation rate (ESR) 44 mm/hr. Stool studies show the presence of WBC but no blood. Which intervention is appropriate at this time?

Which of the following patients requires no further testing before making the diagnosis of irritable bowel syndrome and initiating treatment?

A 22-year-old female medical student registers with a new GP. On her health questionnaire, she states that she has been diagnosed with irritable bowel syndrome (IBS). Which one statement about IBS is true?

The following are subgroups of IBS EXCEPT.

A 31-year-old woman who initially presented with abdominal pain and constipation is diagnosed with irritable bowel syndrome. Which one of the following bits of dietary advice is it least suitable to give?

A 30-year-old woman presents with abdominal pain that is associated with alternating diarrhoea and constipation. Which one of the following symptoms is least consistent with a diagnosis of irritable bowel syndrome?

A patient presents with gastrointestinal symptoms. Which one of the following features in the history would be least consistent with making a diagnosis of irritable bowel syndrome?

A 27-year-old woman with chronic left iliac fossa pain and alternating bowel habit is diagnosed with irritable bowel syndrome. Initial treatment is tried with a combination of antispasmodics, laxatives and anti-motility agents. Unfortunately after 6 months, there has been no significant improvement in her symptoms. According to recent NICE guidelines, what is the most appropriate next step?

A 28-year-old woman is diagnosed with irritable bowel syndrome (IBS). She occasionally experiences spasms of pain in the left iliac fossa and has periods of both constipation and loose stools. You are considering drug therapy to provide her with symptomatic relief from the symptoms. Which one of the following does NICE recommend that we avoid in patients with IBS?

According to recent NICE guidelines, which one of the following may have a role in the management of irritable bowel syndrome?

A 39-year-old woman presents with a strange collection of symptoms over the past six months. Multiple specialists have seen her, none of whom have been able to find a cause for her symptoms. Her symptoms include worsening headaches, memory loss, low mood, lethargy, abdominal pain causing paroxysms of intermittent generalized pain, nausea, an unusual taste in her mouth, and paraesthesia in her extremities. She is irritable during your consultation and at times tearful, complaining that no one is taking her seriously and confiding that her General Practitioner had referred her for counseling. Routine blood tests show: Hb 101g/L WBC 5.6 10*9/L Platelets 350 10*9/L MCV 77fL Na 136mmol/L K 4.3mmol/L Urea 18.2mmol/L Creatinine 408umol/L What is the likely cause of her symptoms?

A 28-year-old bank-accountant man presented with diarrhea of 10 months’ duration. He denies experiencing weight loss or other constitutional symptoms. He notes no blood in the stool. He has no medical history. He explains that he has not sought attention before now because the problem is intermittent, and he notes that he sometimes experiences constipation rather than diarrhea. You include irritable bowel syndrome in your differential diagnosis. Which of the following descriptions is characteristic of irritable bowel syndrome?

A 28-year-old bank-accountant man presented with diarrhea of 10 months’ duration. He denies experiencing weight loss or other constitutional symptoms. He notes no blood in the stool. Which of the following is the best initial treatment option for his diarrhea ?

A 26-year-old man presents with intermittent crampy abdominal pain, diarrhea without noticeable blood, and weight loss of 15 lb over 10 months. The bowel symptoms, including diarrhea, wake him from sleep. On a few occasions, he has had fevers, nausea, and vomiting. The patient is an architect, and he describes his work as being stressful; he resumed smoking cigarettes a year ago. On examination, the patient is a slender man with normal vital signs. He has an oral aphthous ulcer and poorly localized lower abdominal to midabdominal tenderness without peritoneal signs. Anal and rectal examinations are normal, and a stool guaiac test is negative. Stool leukocytes are present. The hematocrit is 34%. Results of examination with flexible sigmoidoscopy are normal. Which of the following is the most likely diagnosis for this patient?

A 25-year-old woman presents with lower abdominal pain and periods of constipation alternating with episodes of diarrhea. Her previous physician diagnosed her with irritable bowel after an extensive evaluation. She takes a selective serotonin reuptake inhibitor for depression but has no other significant medical history. Which of the following abnormalities is NOT present in patients with functional gastrointestinal disorders?

A 25-year-old woman presents with lower abdominal pain and periods of constipation alternating with episodes of diarrhea. Her previous physician diagnosed her with irritable bowel after an extensive evaluation. His follow should include

A 46-year-old teacher presented with a 5-month history of profuse diarrhoea despite fasting, and associated abdominal bloating. She complained of increasing fatigue and appeared dehydrated. Investigations: haemoglobin 125 g/L (130–180) serum sodium 138 mmol/L (137–144) serum potassium 1.9 mmol/L (3.5–4.9) serum urea 7.3 mmol/L (2.5–7.0) serum creatinine 105 μmol/L (60–110) plasma viscosity 1.76 mPa/s (1.50–1.72) Which of the following is the most likely diagnosis?

A 40-year-old man presented for the first time to your outpatient clinic. He had recurrent abdominal pain which improved with defecation, and mushy stools up to three times a day for the last 4 months. He denied weight loss, rectal bleeding, or a family history of colorectal cancer. Investigations: stool microscopy, culture, and sensitivity negative for ova, cysts, and parasites. Which of the following is the next most appropriate management step? A. Abdominal ultrasound.

A 25-year-old girl with constipation-predominant irritable bowel syndrome (C-IBS) was referred to clinic with ongoing anal pain. She described excruciating pain on defecation with hard stools. On rectal examination, her GP had identified an anal fissure. Treatment with warm baths, stool softeners, and topical anaesthetic gels had failed to provide relief. What would be the next most appropriate treatment?

A 38-year-old man presented to the gastroenterology outpatient clinic for the first time. He complained of recurrent abdominal pain every other day for the last 3 months. Which of the following symptoms most favors a diagnosis of irritable bowel syndrome?

Rome III Criteria for Diagnosis of Irritable Bowel Disease include all the following except

After a careful history and physical and a cost-effective workup, you have diagnosed a 24-year old woman patient with irritable bowel syndrome. What other condition would you reasonably expect to find in this patient?

A 29-year-old woman presented with abdominal discomfort. She feels abdominal discomfort on most days of the week and the pain varies in location and intensity. She notes constipation as well as diarrhea, but diarrhea predominates. Compared to 6 months ago, she has more bloating and flatulence than she has had before. She identifies eating and stress as aggravating factors, and her pain is relieved by defecation. You suspect irritable bowel syndrome. Laboratory data include WBC count 8000/μL, Hb 10 g/dl, platelets 210,000/μL, and erythrocyte sedimentation rate (ESR) 44 mm/hr. Stool studies show the presence of WBC but no blood. Which intervention is appropriate at this time?

A 27-year-old woman with chronic left iliac fossa pain and alternating bowel habit is diagnosed with irritable bowel syndrome. Initial treatment is tried with a combination of antispasmodics, laxatives and anti-motility agents. Unfortunately after 6 months, there has been no significant improvement in her symptoms. According to recent NICE guidelines, what is the most appropriate next step?

A 28-year-old woman is diagnosed with irritable bowel syndrome (IBS). She occasionally experiences spasms of pain in the left iliac fossa and has periods of both constipation and loose stools. You are considering drug therapy to provide her with symptomatic relief from the symptoms. Which one of the following does NICE recommend that we avoid in patients with IBS?

A 39-year-old woman presents with a strange collection of symptoms over the past six months. Multiple specialists have seen her, none of whom have been able to find a cause for her symptoms. Her symptoms include worsening headaches, memory loss, low mood, lethargy, abdominal pain causing paroxysms of intermittent generalized pain, nausea, an unusual taste in her mouth, and paraesthesia in her extremities. She is irritable during your consultation and at times tearful, complaining that no one is taking her seriously and confiding that her General Practitioner had referred her for counseling. Routine blood tests show: Hb 101g/L WBC 5.6 10*9/L Platelets 350 10*9/L MCV 77fL Na 136mmol/L K 4.3mmol/L Urea 18.2mmol/L Creatinine 408umol/L What is the likely cause of her symptoms?

A 28-year-old bank-accountant man presented with diarrhea of 10 months’ duration. He denies experiencing weight loss or other constitutional symptoms. He notes no blood in the stool. He has no medical history. He explains that he has not sought attention before now because the problem is intermittent, and he notes that he sometimes experiences constipation rather than diarrhea. You include irritable bowel syndrome in your differential diagnosis. Which of the following descriptions is characteristic of irritable bowel syndrome?

A 26-year-old man presents with intermittent crampy abdominal pain, diarrhea without noticeable blood, and weight loss of 15 lb over 10 months. The bowel symptoms, including diarrhea, wake him from sleep. On a few occasions, he has had fevers, nausea, and vomiting. The patient is an architect, and he describes his work as being stressful; he resumed smoking cigarettes a year ago. On examination, the patient is a slender man with normal vital signs. He has an oral aphthous ulcer and poorly localized lower abdominal to midabdominal tenderness without peritoneal signs. Anal and rectal examinations are normal, and a stool guaiac test is negative. Stool leukocytes are present. The hematocrit is 34%. Results of examination with flexible sigmoidoscopy are normal. Which of the following is the most likely diagnosis for this patient?

A 25-year-old woman presents with lower abdominal pain and periods of constipation alternating with episodes of diarrhea. Her previous physician diagnosed her with irritable bowel after an extensive evaluation. She takes a selective serotonin reuptake inhibitor for depression but has no other significant medical history. Which of the following abnormalities is NOT present in patients with functional gastrointestinal disorders?

A 46-year-old teacher presented with a 5-month history of profuse diarrhoea despite fasting, and associated abdominal bloating. She complained of increasing fatigue and appeared dehydrated. Investigations: haemoglobin 125 g/L (130–180) serum sodium 138 mmol/L (137–144) serum potassium 1.9 mmol/L (3.5–4.9) serum urea 7.3 mmol/L (2.5–7.0) serum creatinine 105 μmol/L (60–110) plasma viscosity 1.76 mPa/s (1.50–1.72) Which of the following is the most likely diagnosis?

A 40-year-old man presented for the first time to your outpatient clinic. He had recurrent abdominal pain which improved with defecation, and mushy stools up to three times a day for the last 4 months. He denied weight loss, rectal bleeding, or a family history of colorectal cancer. Investigations: stool microscopy, culture, and sensitivity negative for ova, cysts, and parasites. Which of the following is the next most appropriate management step? A. Abdominal ultrasound.

A 25-year-old girl with constipation-predominant irritable bowel syndrome (C-IBS) was referred to clinic with ongoing anal pain. She described excruciating pain on defecation with hard stools. On rectal examination, her GP had identified an anal fissure. Treatment with warm baths, stool softeners, and topical anaesthetic gels had failed to provide relief. What would be the next most appropriate treatment?

A 39-year-old woman presents with a strange collection of symptoms over the past six months. Multiple specialists have seen her, none of whom have been able to find a cause for her symptoms. Her symptoms include worsening headaches, memory loss, low mood, lethargy, abdominal pain causing paroxysms of intermittent generalized pain, nausea, an unusual taste in her mouth, and paraesthesia in her extremities. She is irritable during your consultation and at times tearful, complaining that no one is taking her seriously and confiding that her General Practitioner had referred her for counseling. Routine blood tests show: Hb 101g/L WBC 5.6 10*9/L Platelets 350 10*9/L MCV 77fL Na 136mmol/L K 4.3mmol/L Urea 18.2mmol/L Creatinine 408umol/L What is the likely cause of her symptoms?

A 26-year-old man presents with intermittent crampy abdominal pain, diarrhea without noticeable blood, and weight loss of 15 lb over 10 months. The bowel symptoms, including diarrhea, wake him from sleep. On a few occasions, he has had fevers, nausea, and vomiting. The patient is an architect, and he describes his work as being stressful; he resumed smoking cigarettes a year ago. On examination, the patient is a slender man with normal vital signs. He has an oral aphthous ulcer and poorly localized lower abdominal to midabdominal tenderness without peritoneal signs. Anal and rectal examinations are normal, and a stool guaiac test is negative. Stool leukocytes are present. The hematocrit is 34%. Results of examination with flexible sigmoidoscopy are normal. Which of the following is the most likely diagnosis for this patient?