A 33-year-old female complains of escalating spastic pain in the abdomen after the psycho-emotional stress. The patient has intermittent bowel movements, that is 2-3 bowel movements after waking up alternate with constipation lasting for 1-2 days. Objectively: body weight is unchanged, there is moderate pain on palpation of the sigmoid colon. Hb- 130 g/l, WBC- 5,2 × 109/l, ESR - 9 mm/h. Proctosigmoidoscopy causes pain due to spastic bowel condition, intestinal mucosa is not changed. In the lumen there is a lot of mucus. What is the most likely diagnosis?

Answer options

1. Acute bowel ischemia
2. Irritable bowel syndrome
3. Malabsorption syndrome
4. Non-specific ulcerative colitis
5. Crohn’s disease

Explanation

A 33-year-old female complains of escalating spastic pain in the abdomen after the psycho-emotional stress. The patient has intermittent bowel movements, that is 2-3 bowel movements after waking up alternate with constipation lasting for 1-2 days. Objectively: body weight is unchanged, there is moderate pain on palpation of the sigmoid colon. Hb- 130 g/l, WBC- 5,2 • 109/l, ESR- 9 mm/h. Proctosigmoidoscopy causes pain due to spastic bowel condition, intestinal mucosa is not changed. In the lumen there is a lot of mucus. What is the most likely diagnosis?Diagnostic Criteria for Irritable Bowel Syndrome (IBS) :Recurrent abdominal pain or discomfort at least 3 days/month in the last 3 months. Plus two or more of the followingImprovement with defecationchange in frequency of stoolchange in stool form(appearance) Note: There are no pathological changes in the bowel.