PassMedicine details

Question 1

Symptoms seen in IBS

Answer 1

abdominal pain, and/or
bloating, and/or
change in bowel habit

Also: lethargy, nausea, backache and bladder symptoms.

"A positive diagnosis of IBS should be made if the patient has abdominal pain relieved by defecation or associated with altered bowel frequency stool form, in addition to 2 of the following 4 symptoms:
altered stool passage (straining, urgency, incomplete evacuation)
abdominal bloating (more common in women than men), distension, tension or hardness
symptoms made worse by eating
passage of mucus"

Question 2

Which red flag abdominal features should be enquired about?

Answer 2

rectal bleeding
unexplained/unintentional weight loss
family history of bowel or ovarian cancer
onset after 60 years of age

Question 3

What’s the coeliac disease screen?

Answer 3

tissue transglutaminase antibodies

Question 4

Abdominal features of U/C?

Answer 4

bloody diarrhoea
urgency
tenesmus
abdominal pain, particularly in the left lower quadrant

Question 5

Extra-abdominal features of IBS:

Answer 5

Arthritis: pauciarticular, asymmetric
Erythema nodosum
Episcleritis
Osteoporosis
Uveitis
Pyoderma gangrenosum
Clubbing
Primary sclerosing cholangitis

Question 6

Key differences (U/C as compared to Crohn’s?)

Answer 6

UC always starts at rectum (hence it is the most common site for UC), never spreads beyond ileocaecal valve and is continuous.