Question

A 35-year-old man presents to an urban GP with a 3-month history of episodic crampy abdominal pain, bloating and altered bowel habit (diarrhoea and constipation). He has lost 3 kg unintentionally. Family history reveals colorectal cancer in his father at age 50. Examination and basic blood tests are unremarkable. What is the most appropriate next step?

Accepted Answer

Arrange colonoscopy to evaluate for organic pathology

Answer

Diagnose irritable bowel syndrome and provide reassurance only

Answer

Start antispasmodics and high-fibre diet without further investigation

Answer

Order abdominal ultrasound and treat if normal as IBS

Answer

Repeat review in 6 months before arranging further tests

Practice question