AANP Family Nurse Practitioner (FNP) Certification ExamAssessmentMedium
A 38-year-old female presents with a 3-month history of intermittent abdominal pain, bloating, and alternating constipation and diarrhea. The pain is often relieved by defecation. She denies weight loss, fever, or nocturnal symptoms. Physical examination is unremarkable. Which of the following diagnostic criteria is most appropriate to confirm the diagnosis?
- AColonoscopy with biopsies.
- BAbdominal CT scan.
- CRome IV criteria.
- DStool studies for infection and inflammation.
Show answer & explanationAnswer & explanation
Correct answer: C. Rome IV criteria.
The patient's symptoms (recurrent abdominal pain associated with defecation, change in stool frequency/form, bloating, and absence of alarm symptoms) are classic for Irritable Bowel Syndrome (IBS). The Rome IV criteria are the established diagnostic criteria for IBS, based on symptom patterns.
Why the other options are wrong
- A. Colonoscopy is not routinely indicated for IBS diagnosis in the absence of alarm symptoms.
- B. An abdominal CT scan would not diagnose IBS and is only indicated if alarm symptoms suggest other pathology.
- D. Stool studies are important to rule out infection or inflammatory bowel disease if alarm symptoms are present, but not for typical IBS diagnosis.
IBS Diagnosis (Rome IV)
Irritable Bowel Syndrome (IBS) is a functional gastrointestinal disorder characterized by chronic, recurrent abdominal pain associated with defecation or a change in bowel habits, without any identifiable organic cause.
- Diagnosis is made using the Rome IV criteria, which are symptom-based.
- Absence of 'alarm symptoms' (e.g., weight loss, nocturnal diarrhea, GI bleeding) is crucial.
- Subtypes include IBS-C (constipation-predominant), IBS-D (diarrhea-predominant), and IBS-M (mixed).
Memory trick: IBS Rome: Right On My Esophagus, My Everything!