Question

A 34-year-old male comes to the clinic complaining of abdominal pain. He says the pain has been bothering him for the past two weeks. He reports episodes of diarrhea and constipation, with more episodes of constipation. He states he has noticed an increase in flatulence. He denies any nausea or vomiting. He has noticed mucus in his stools, but no blood. He states that he cannot recall if anything aggravates the pain, but admits to being under more stress than usual, due to his mother-in-law moving in with him and his wife. Vital signs show a blood pressure of 124/76, pulse of 74, respirations of 16, a temperature of 97.9, and oxygen saturation of 98% on room air. Physical exam is unremarkable. The most appropriate initial step in management is:

Answer 1

Performing a CBC, TSH, complete metabolic panel, and stool studies. Likely IBS though.