22nd July 2023

A 37-year-old woman with a history of fibromyalgia is referred to gastroenterology having presented to her GP

A 37-year-old woman with a history of fibromyalgia is referred to gastroenterology having presented to her GP on 6 occasions in the last 4 months with loose stools. Her symptoms began 8 months ago. She opens her bowels twice a day and describes her stool as “almost liquid” with occasional mucus and no blood. She also reports that her generalised body pain has worsened over the last 2 months and she feels tired all the time. She has intermittent nausea but denies vomiting, abdominal pain, weight loss and blood loss. She denies laxative use. Clinical examination, including a PR examination, is unremarkable. Her GP has performed numerous tests, including full blood count, renal and liver function, thyroid function, coeliac serology, CRP, ESR, faecal calprotectin and stool microscopy and culture – all of the results are within normal limits.

Which criteria is used to diagnose the most likely underlying pathology?

Select the SINGLE most appropriate option from the list below. Select ONE option only.