Signs and Symptoms

Question 1

What are the red flags for further investigations in secondary care?

Answer 1

• Over 60
• Rectal bleeding
• Anaemia
• Weight loss
• FH of colorectal cancer
• Abdo/rectal mass
• Raised CRP/ESR or faecal calprotectin

Question 2

How do you diagnose IBS?

Answer 2

If recurrent abdominal pain (or discomfort) associated with at least 2 of:

• Relief by defecation
• Altered stool form
• Altered bowel frequency (constipation and diarrhoea may alternate)

Question 3

What are features of IBS?

Answer 3

• Urgency
• Incomplete evacuation
• Abdominal bloating/distension
• Mucus PR
• Worsening of symptoms after food
• Symptoms are chronic and often exacerbated by stress, menstruation or gastroenteritis

Question 4

What is Carnett’s sign?

Answer 4

Tested for to determine whether pain originates from viscera or myofascia/abdominal wall. Patient should lie down and raise head or legs against resistance, test is positive if this exacerbates pain which indicates abdominal wall.

Question 5

What are the signs and symptoms of IBD?

Answer 5

• Diarrhoea
• Rectal bleeding
• Abdominal pain
• Tenesmus
• Fever
• Weight loss
• Vomiting
• Cramps
• Muscle spasms