Functional bowel disorders

Question 1

What are the criteria for IBS?

Answer 1

• improvement in symptoms with defecation
• onset assoc. with change in stool freq.
• onset assoc. with change in stool form
• symptoms for 3 days/month for 3 straight month. Need 2/3 previous criteria.

If there are no red flags, make the positive diagnosis and start treatment and follow up in a month!! (no need for imaging/ procedures, unless red flags present.)

Question 2

Red flag symptoms (history) that require further investigation if you encounter them in a pt who you think has IBS

Answer 2

bleeding, 
wt loss, 
night symptoms (symptoms should get better when you're not eating), 
family history, 
>50 years old (unlikely to be IBS)

Question 3

Red flag symptoms (physical exam) that require further investigation if you encounter them in a pt who you think has IBS

Answer 3

• rash
• malnutrition
• inflammatory arthropathy
• abdominal mass