MBBS OSCE · gastroenterology
OSCE — Irritable Bowel Syndrome
Eight-minute OSCE station on Irritable Bowel Syndrome: focused history, examination priorities, investigations, emergency and definitive management.
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Brief (to candidate)
You will assess a patient with a presentation consistent with Irritable Bowel Syndrome.
You have 8 minutes to take a focused history, outline examination, investigations, and management including red flags.
Clinical context
Irritable Bowel Syndrome (IBS) is a Disorder of Gut-Brain Interaction (DGBI) defined by the Rome IV criteria as recurrent abdominal pain at least one day per week in the last three months, associated with two or more of: (1) relation to defaecation, (2) associated change in stool frequency, (3) associated change in stool form (appearance) — in the absence of alarm features or structural disease. Prevalence is 10 to 15 percent of adults worldwide, with a female-to-male ratio of about 2:1 and peak onset before age 50. The four Rome IV subtypes are IBS-C (constipation), IBS-D (diarrhoea), IBS-M (mixed) and IBS-U (unclassified); severity is graded mild, moderate or severe by impact on daily acti
Candidate tasks
- Clarify onset, severity, associated features, and red-flag symptoms.
- State focused examination priorities.
- List first-line investigations and any named score/criteria.
- Give immediate resuscitation steps.
- Outline definitive management with doses/routes where standard.
- Name complications and disposition (ward / HDU / theatre / discharge safety-net).
- Mention one special-population modifier (pregnancy, child, elderly, CKD).
Examiner checklist
| Domain | Pass behaviours |
|---|---|
| Definition | Correct working diagnosis language |
| Assessment | Focused, prioritised, red flags sought |
| Investigations | Appropriate first-line + interpretation |
| Emergency care | ABC / time-critical actions first |
| Definitive care | Specific drugs/procedures, not generic phrases |
| Safety | Unintentional weight loss of more than 5 percent of body weight over 6 months - |
| Safety | Gastrointestinal bleeding (haematemesis, melaena, or fresh rectal bleeding) - ex |
| Safety | Iron-deficiency anaemia - exclude occult GI blood loss, coeliac disease, colorec |
| Communication | Clear plan and safety-netting |
Model outline
Lead with the working diagnosis and life threats. Resuscitate before definitive tests when unstable. Use guideline-standard therapy with named agents and doses. Document escalation criteria and follow-up. A safe candidate is specific, structured, and never delays critical care for non-urgent imaging.