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Constipation and recurrent abdominal distension in a 39-year-old woman with irritable bowel syndrome
  1. Seth Sweetser,
  2. Archana S Rao,
  3. Lawrence A Szarka
  1. Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, Rochester, Minnesota, USA
  1. Correspondence to Dr Seth Sweetser, Mayo Clinic, 200 First St SW, Rochester, MN 55905, USA; sweetser.seth{at}mayo.edu

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Clinical presentation

A 39-year-old woman with a previous diagnosis of irritable bowel syndrome presented with progressively worsening episodes of marked abdominal distension and difficulties with defecation. She had a long history of constipation and had tried a variety of laxatives with an unsatisfactory response. Recent colonoscopy was unremarkable. Physical exam revealed a protuberant abdomen with tympany and high-pitched bowel sounds. Inspection of the anus …

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