Ambulatory

Question:

The correct answer is B

Irritable bowel disease (IBS) is a syndrome of chronic intestinal stasis that is usually confined to women under age 35 years. It is typically associated with abdominal pain, bloating, alternating constipation and diarrhea or both. Stress, psychological factors, low-fiber diet and/or anticholinergic medication may precipitate IBS. (196)

IBS is much more common in women, occurring twice as often as in men. The abnormality that causes IBS is unknown and some researchers believe it arises from disturbances in the neurohormonal control of the gastrointestinal tract.

Treatment is increased ingestion of dietary fiber. The patient should start adding fiber to their diet slowly and increase the amounts over a two to four week period of time. The goal should be 20 grams to 30 grams of dietary fiber per day. This can be done by adding bran, fiber additives, vegetables, and psyllium preparations. (189)

References:

189. Rosenfeld JA: Women's Health in Primary Care. Baltimore: Williams and Wilkins, 1997.

196. Bjorkman DJ BR, Tolman KG: Primary care for women with gastrointestinal disorders. Clin Obstet Gynecol 1988; 31: 974-987.

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