Exam Cram

• Moa: "software" issue of brain-bowel connection, functional disorder

• Presentation recurrent abdominal pain associated with diarrhoea and constipation

• Investigations normal, useful to exclude differentials

• Management: symptomatic 

Outline

Assessment

History

• Recurrent abdominal pain associated with defacation

• Diarrhoea and constipation

• > 3 months, any age

Examination

• Normal- abdomen soft, non tender

• No weight loss, hepato-splenomegaly

Investigations

• Normal

  • FBC, EUC, CRP, LFTs

  • TSH, Calcium, Anti-TTG & IgA

  • Faecal calprotectin, occult test

Diagnosis

Diagnostic Criteria Rome IV 2016:  

Recurrent abdominal pain > 1 day per week for 3m, with 2/3

• Related to defecation (improving or worsening)

• Associated with change in stool frequency

• Associated with change in stool appearance

Differentials: 

• GI: IBD, Coeliac Disease, Gluten Intolerance, Giardia Gastroenteritis, Colorectal Cancer 

• Ovarian Cancer, Hypo/ HyperThyroidism, HypoCalcaemia 

Classification: 

• IBS-D: predominant diarrhoea

• IBS-C: predominant constipation

Management

Acute & chronic

• Laxatives for constipation

• Loperamide for diarrhoea

• Dietician: high soluble fibre, low caffeine & alcohol

• Exercise +/- physiotherapy

• Mental health/ sleep hygiene +/- psychologist

Resources and References

Links

• Body system: gastrointestinal & nervous system

• Specialties: Gastroenterology, General Practice

Written in 2025