ROSH Gastrointestinal Practice Exam

What is the likely cause of a patient with intermittent abdominal pain, diarrhea, and distension, who has a history of laparoscopic surgery?

1. Hyperthyroidism

2. Irritable bowel syndrome

3. Opioid analgesics

4. Postoperative adhesions

The correct answer is: Postoperative adhesions

The scenario presented highlights a patient experiencing intermittent abdominal pain, diarrhea, and distension following a history of laparoscopic surgery. In this context, postoperative adhesions are considered the most likely cause of the symptoms. After abdominal surgeries, such as laparoscopic procedures, the formation of adhesions is a common occurrence. Adhesions are bands of fibrous tissue that can form between internal organs and tissues as part of the body's healing process. They can lead to complications, including bowel obstruction or abnormal motility, which can produce symptoms such as abdominal pain and changes in bowel habits, like diarrhea. This aligns with the intermittent nature of the abdominal pain experienced by the patient. The other potential causes outlined do not fit as neatly with the patient's surgical history and symptomatology. Hyperthyroidism might lead to gastrointestinal symptoms, but it typically presents with a wider range of systemic symptoms such as weight loss or increased appetite. Irritable bowel syndrome often presents with chronic symptoms rather than the acute episodes described, and it is less directly related to recent surgical history. Opioid analgesics can cause constipation or other GI issues, but they do not explain the patient's history of surgery and the acute nature of the symptoms. Hence, considering the surgical history and the nature of the symptoms,