A 28-year-old white woman presents to your office with a chief…

Question Answered step-by-step A 28-year-old white woman presents to your office with a chief… A 28-year-old white woman presents to your office with a chief complaint of constipation and abdominal pain. On further questioning, she reports she has had this problem since beginning college at the age of 18. Her symptoms have waxed and waned since this time, but never have worsened. She described her of abdominal pain as dull, crampy, and non-focal but more prominent in the left lower quadrant and improved with defecation. She denies radiation of pain, nausea, vomiting, fever, chills, weight loss, heartburn, or bloody or dark stool. She reports that over the last three months she is having cramps 7 to 10 times per month and having a bowel movement every 1 to 2 days that is hard and feels incomplete. She has tried over-the-counter remedies, including stool softeners and antacids, but only experienced minimal improvement in her symptoms. She only takes birth control pills and denies any use of herbal supplements or laxatives. Her family history is negative, including for colorectal cancer and inflammatory bowel disease, and she reports that her parents and siblings are healthy. She is currently engaged and reports significant stress in preparing for the wedding. On physical exam, you note her to be somewhat anxious, but otherwise in no apparent distress. Her vital signs and general physical exam are normal. Her abdomen has normal bowel sounds, no tenderness on superficial and deep palpation, and no rebound, rigidity, or guarding. Liver and spleen size are within normal limits and no masses are palpable. A pelvic examination is normal. The rectal examination shows normal sphincter tone, no masses, and brown stool that is occult blood negative.  1. Describe the epidemiology, clinical manifestations, and pathophysiology of IBS. 2. What is the diagnostic approach to IBS and the rationale for ordering diagnostic studies based on symptom subtype and/or presence of “alarm features?” 3. What are the current therapeutic strategies for a patient with IBS? 4. What is the role of psychosocial factors in IBS?  Health Science Science Nursing NURSING 531 Share QuestionEmailCopy link Comments (0)