Which one of the following is not a feature of irritable bowel syndrome?

Ans. is 'c' i.e., Rectal bleeding Rectal bleeding is a feature against the diagnosis of irritable bowel syndrome.Irritable bowel syndrome is a gastrointestinal disorder that is characterized by altered bowel habits and abdominal pain in the absence of detectable structural abnormalities.No clear diagnostic markers exist for IBS, thus all the definitions of the disease are based on the clinical presentation.Abdominal painIt is a prerequisite clinical feature of IBS.Abdominal pain in IBS is highly variable in intensity and location. Most commonly it is localized to hypogastrium.Altered bowel habitsAlteration in bowel habit is the most consistent clinical feature The most common pattern is constipation alternating with diarrhoea.Gas and flatulencePatients with IBS frequently complain of abdominal distension and increased belching or flatulence, all of which they attribute to increased gas.Upper Gastrointestinal SymptomsBetween 25-50% of patients with IBS complain of dyspepsia, heart burns, nausea and vomiting.Remember that no anatomic, microbiological or biochemical abnormality has been demonstrated in these patients.Also knowRome II criteria for diagnosis of IBSAt least 12 weeks, which need not be consecutive in the preceding 12 months of abdominal discomfort or pain that has two of following three features.Relieved by defecationOnset associated with changes in stool frequencyOnset associated with changes in stool form.Features which are against the diagnosis of IBS late age of onset of symptoms (> 40 years) large volume diarrhoea or steatorrheafrequent nocturnal symptoms blood in stools (except from anal lesion e.g. hemorrhoids, fissure)progression of symptomsfever significant weight loss