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Irritable Bowel Syndrome: Assessing the Abdomen Essay

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Updated: Jul 14th, 2021

The complaint of diarrhea can signify many conditions some of which are not directly connected to the symptom. Based on the available information about the patient, it is impossible to propose a conclusive diagnosis. Therefore, a clinician should gather additional information about the patient’s health. While the diagnosis of gastroenteritis cannot be eliminated, it also cannot be fully supported with evidence. Some possible conditions include IBS (irritable bowel syndrome), diverticulitis, and viral gastroenteritis (for instance, rotavirus), although additional tests can reveal a connection to other organs and systems.

Additional Information

First of all, it is vital for the medical professional to collect additional subjective information. The patient’s description of abdominal pain is too broad to outline the list of diagnoses. Pain can be defined as sharp or dull; it can come in short bursts or be constant (Sullivan, 2019). Moreover, the patient does not specify whether the pain is localized. All mentioned above descriptors signify different issues – for example, sharp localized pain can be a characteristic of ulcers (Magro et al., 2017).

The location of pain also plays a vital role in diagnosing. If the patient points at the location of the appendix or states that the feeling spreads throughout the abdomen, he may have appendicitis, among other conditions. Thus, a detailed description of pain is required. Additionally, the history of diarrhea, constipation, and other related symptoms need to be acquired. The existence of persistent pain or interchangeable diarrhea and constipation may reveal a chronic disorder (Ball, Dains, Flynn, Solomon, & Stewart, 2015). As the patient has a history of gastrointestinal bleeding, this further assessment will be helpful.

Diagnostic Tests

The absence of performed diagnostics makes it impossible to investigate potential conditions. One should perform a blood test that can reveal inflammatory diarrhea. It is also used to test for dehydration – a common symptom of infections (Humphries, & Linscott, 2015). Furthermore, a stool culture test will show the presence of bacteria, viruses, or parasites. This diagnostic can also find whether the stool contains blood. An abdominal ultrasound shows the state of one’s gastrointestinal tract and helps to diagnose such conditions as diverticulitis (Sartelli et al., 2016). Overall, the combination of blood, stool, and imaging tests should be the basis for selecting differential diagnoses.

Differential Diagnoses

While the description of the patient’s condition is vague, one can suggest a number of possible diagnoses that are characterized by abdominal pain and diarrhea. The first of them is viral gastroenteritis, an infection that is caused by viruses. It is defined by such symptoms as diarrhea, nausea, fever, and abdominal cramps. If the patient is dehydrated, has persistent diarrhea, and has blood in his stool, he may have this condition.

Moreover, body ache is another sign of infection; here, a stool sample is necessary to reveal the existence of a virus in the body (Shane et al., 2017). Another version of this infection is gastroenteritis caused by bacteria. It is similar to the above-described condition, presenting with dehydration, diarrhea, and abdominal pain (Humphries, & Linscott, 2015). A stool culture test is the most reliable way of supporting this diagnosis.

The patient’s pain can also be connected to diverticulitis, a disorder that affects the large intestine. It is characterized by pain in the lower left part of the abdomen a similar feature to the information mentioned in the objective assessment (Sartelli et al., 2016). Other symptoms may include fever, vomiting, and diarrhea or constipation. The analysis of the patient’s dieting habits, use of certain medications, and physical activity can support this diagnosis. A blood test may reveal liver or kidney problems as well as signs of inflammation. An imaging test can eliminate or confirm diverticulitis.

The third possible disorder is IBS (Irritable Bowel Syndrome), although the signs for this condition are usually monitored for an extended period of time before making a conclusive diagnosis. IBS is characterized by abdominal pain, cramps, bloating, and diarrhea or constipation (Chey, Kurlander, & Eswaran, 2015). In some patients, the last two symptoms interchange, while in others only one of these problems persists.

It is necessary to note that the patient should describe his pain as cramps which subside after a bowel movement. The patient’s history of gastrointestinal bleeding implies that he may have untreated conditions. If his examination does not reveal any causes of infection, IBS can be considered. Here, a colonoscopy is performed to rule out other diagnoses such as colitis, Crohn’s disease, or even cancer.

Conclusion

The lack of data in the note does not allow one to come to a conclusive diagnosis. Such conditions as IBS, gastroenteritis, and diverticulitis can be analyzed among others. The patient has to describe his pain in more detail, talking about its location and character. Moreover, the clinician should order multiple tests to check for infection, blood in the stool, anemia, and other signs. A blood test and a stool culture test are vital for the elimination of bacteria, viruses, and parasites. An ultrasound can show the current state of the organs and reveal inflammations. If the causes of the pain remain unclear after these diagnostics, one can perform a colonoscopy.

References

Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2015). Seidel’s guide to physical examination (8th ed.). St. Louis, MO: Elsevier Mosby.

Chey, W. D., Kurlander, J., & Eswaran, S. (2015). Irritable bowel syndrome: A clinical review. JAMA, 313(9), 949-958.

Humphries, R. M., & Linscott, A. J. (2015). Laboratory diagnosis of bacterial gastroenteritis. Clinical Microbiology Reviews, 28(1), 3-31.

Magro, F., Gionchetti, P., Eliakim, R., Ardizzone, S., Armuzzi, A., Barreiro-de Acosta, M.,… Langner, C. (2017). Third European evidence-based consensus on diagnosis and management of ulcerative colitis. Part 1: Definitions, diagnosis, extra-intestinal manifestations, pregnancy, cancer surveillance, surgery, and ileo-anal pouch disorders. Journal of Crohn’s and Colitis, 11(6), 649-670.

Sartelli, M., Catena, F., Ansaloni, L., Coccolini, F., Griffiths, E. A., Abu-Zidan, F. M.,… Moore, F. A. (2016). WSES Guidelines for the management of acute left sided colonic diverticulitis in the emergency setting. World Journal of Emergency Surgery, 11(1), 37.

Shane, A. L., Mody, R. K., Crump, J. A., Tarr, P. I., Steiner, T. S., Kotloff, K.,… Cantey, J. (2017). 2017 Infectious Diseases Society of America clinical practice guidelines for the diagnosis and management of infectious diarrhea. Clinical Infectious Diseases, 65(12), e45-e80.

Sullivan, D. D. (2019). Guide to clinical documentation (3rd ed.). Philadelphia, PA: F. A. Davis.

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IvyPanda. 2021. "Irritable Bowel Syndrome: Assessing the Abdomen." July 14, 2021. https://ivypanda.com/essays/irritable-bowel-syndrome-assessing-the-abdomen/.

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IvyPanda. (2021) 'Irritable Bowel Syndrome: Assessing the Abdomen'. 14 July.

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