Irritable Bowel Syndrome: The Daily PANCE Blueprint
A 29-year-old woman presents with intermittent abdominal pain and altered bowel habits, including periods of diarrhea alternating with constipation, over the past 6 months. Her symptoms improve with defecation. There is no weight loss, GI bleeding, or nocturnal symptoms. Laboratory studies, including CBC, CRP, and stool studies, are unremarkable. What diagnostic criteria are most appropriate for confirming this patient’s condition?
A. Ranson criteria
B. Rome criteria
C. Manning criteria
D. Glasgow-Blatchford score
E. Light’s criteria
Answer and topic summary
The answer is B. Rome criteria
Irritable bowel syndrome is a chronic GI disorder characterized by abdominal pain, changes in bowel habits, and bloating with no structural or biochemical abnormality; it is a positive clinical diagnosis, not a diagnosis of exclusion. It’s very common and accounts for up to 50% of visits to gastroenterologists. The etiology is unknown, but some believe there may be an environmental trigger. Diagnosis is made by the Rome criteria. The current Rome V criteria require recurrent, but not continuous, abdominal pain or discomfort on average at least 3 days per month for the past 3 months, plus 2 or more of: related to defecation, change in stool frequency, or change in stool form. Initial labs depend on if the patient presents with constipation or diarrhea, but may include CBC, CMP, TSH, serologic testing for celiac disease, fecal lactoferrin . Make sure to watch out for alarm signs that point to another, more serious diagnosis (e.g., overt GI bleeding, weight loss, palpable mass).
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Covered under ⇒ PANCE Blueprint GI and Nutrition ⇒ ⇒
