American Board of Internal Medicine (ABIM) Certification Practice Exam

What symptom pattern is characteristic of irritable bowel syndrome (IBS)?

1. Recurrent abdominal discomfort for less than 3 days/month

2. Abdominal pain relieved by medications

3. Recurrent abdominal discomfort for >=3 days/month with changes in bowel habits

4. Constant abdominal pain with no symptom relief

The correct answer is: Recurrent abdominal discomfort for >=3 days/month with changes in bowel habits

The characteristic symptom pattern of irritable bowel syndrome (IBS) includes recurrent abdominal discomfort occurring on average at least three days per month and associated with a change in the frequency or form of bowel movements. This criterion aligns with the diagnostic criteria established by the Rome consensus, which defines IBS based on the presence of symptoms that are typically chronic and recurring rather than isolated or infrequent. IBS symptoms are often linked to changes in bowel habits, such as diarrhea or constipation, and these changes can vary over time. The condition is functional in nature and does not show structural abnormalities, which is a crucial aspect of understanding and diagnosing it. Moreover, abdominal discomfort is a key feature, often described as cramping or bloating, and is typically relieved by bowel movements. This pattern underscores the importance of recurrent involvement of abdominal symptoms that correlate with alterations in bowel habits, distinguishing IBS from other gastrointestinal disorders that may present differently.