A 16-year-old girl is seen in the emergency department with intermittent episodes of loose stools and recurrent dull, crampy abdominal pain felt at the periumbilical area. Based on the assessment, what disorder is most likely?


• Irritable bowel syndrome causes intermittent episodes of loose or normal stools and/or recurrent abdominal pain.

• Irritable bowel syndrome or chronic nonspecific diarrhea appears twice as often in girls than in boys and more often in people under age 45. The cause is unknown, but it does run in families and is associated with depression and other mental health issues, and some dietary factors such as low fat intake (without fat to slow absorption, stool passes rapidly through the bowel) or excessive fluid intake. The episodes of diarrhea may occur several times a week or as frequently as twice a day.

Incorrect options:

• Appendicitis is the inflammation of the appendix. Typically the symptoms include RLQ pain, vomiting, and a later sign of fever.

• Peptic ulcers will lead to symptoms of pain, blood in stools, and vomiting.

• Children with Crohn’s disease develop severe, recurrent diarrhea.

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