A 55-year-old female complains of alternating constipation and diarrhea, lower abdominal pain, and bloating for several months. She has no family history of colon cancer. Her recent mammogram was normal. The patient also mentions she has been feeling very stressed at work lately. What is your approach?
While her symptoms could suggest a range of gastrointestinal issues, from irritable bowel syndrome (IBS) to inflammatory bowel disease (IBD), or even colorectal cancer, the alternating bowel habits, lower abdominal pain, and bloating are classic symptoms of IBS, which can be exacerbated by stress. However, due to her age and the chronicity of the symptoms, a colonoscopy might be recommended to rule out IBD or colorectal cancer. The mammogram result, while important for her overall health, does not directly correlate with her current symptoms. Her stress levels also need addressing, as they can have a substantial impact on IBS.