Question

A young girl presents with abdominal pain and a recent change in bowel habit, with passage of mucus in the stool. There is no associated blood in the stool and the symptoms are increased with stress. The most likely diagnosis is:

• A. Irritable bowel syndrome
• B. Ulcerative colitis
• C. Crohn's disease
• D. Amebiasis

Hint:

Mucus without blood plus a strong stress link in a young patient is functional bowel disease.

Answer 1

The Correct Option is A

Step 1: Collect the features. A young patient has abdominal pain, a change in bowel habit, mucus in the stool, no blood, and clear worsening with stress.

Step 2: Recognise the pattern. Abdominal pain relieved or altered by defecation, change in stool frequency or form, mucus with the stool, the absence of blood, and a strong link to stress make up the classic profile of irritable bowel syndrome, a functional disorder of gut-brain interaction.

Step 3: Note the alarm features that are absent. There is no blood in the stool, no weight loss, and no fever. The lack of these red flags argues strongly against an organic inflammatory or infective cause.

Step 4: Rule out the distractors. Ulcerative colitis causes bloody, mucoid diarrhoea with tenesmus, so the absence of blood argues against it. Crohn disease causes pain, weight loss, and often perianal disease or systemic features, not a stress-linked functional pattern. Amebiasis produces dysentery with blood and mucus, again with blood that is absent here.

The answer is option A, irritable bowel syndrome.