A 36-year female complaints of abdominal pain & constipation since 5 years. She has on & off rectal bleed when she tries to defecate forcefully. The most probable diagnosis is:: (A) Ulcerative colitis, (B) Crohn's disease, (C) Tuberculous intestine, (D) Irritable bowel syndrome
Answer is D. The findings are consistent with irritable bowel syndrome. Crohn's disease would typically have perianal fistulae while ulcerative colitis has periods of acute disease and quiescent periods: the acute periods are severe and may lead to significant impairement.