Gastroenterology · Model history
Abdominal cramps and loose stools: a model history
- Setting
- Outpatient gastroenterology clinic
- Patient
- Mr. Davies, 31, has had abdominal cramps and loose stools for over a year.
- Listen
- 4 min
After listening
Say the next question
Read the patient’s answer, say your next question aloud, then reveal the model.
“An older cousin has Crohn's disease. That's what has me worried.”
Acknowledge the concern, then ask one question about function or the patient’s goal.
How is this affecting you day to day, and what were you hoping we could help with?
Model interview
Full transcript
- Doctor
Mr. Davies, I'm Dr. Patel. What would you like us to focus on today?
- Patient
For more than a year I've had stomach cramps and loose bowel movements. It's getting difficult to manage at work.
- Doctor
Tell me what a typical episode is like, from the beginning.
- Patient
I get cramping low down in my abdomen, then I suddenly need the bathroom. The stool is usually loose and watery.
- Doctor
How often does that happen, and how long has this pattern been going on?
- Patient
Three or four days most weeks. It started about fourteen months ago.
- Doctor
What happens to the cramping after you have a bowel movement?
- Patient
It usually eases within about half an hour.
- Doctor
Besides the cramping and loose stool, do you get bloating, nausea, or vomiting?
- Patient
I get very bloated by late afternoon. No nausea or vomiting.
- Doctor
Do the symptoms ever wake you at night? Have you noticed blood in the stool?
- Patient
No to both. Once I'm asleep, they don't wake me, and I've never seen blood.
- Doctor
Have you had a fever, lost weight without trying, or felt unusually tired or weak?
- Patient
No fever or weight loss. I work long hours, so I'm tired sometimes, but not in a new way.
- Doctor
Any greasy stool, very pale stool, or trouble flushing it away?
- Patient
No. It's loose, but I haven't noticed anything like that.
- Doctor
Have you noticed any foods, drinks, medicines, travel, or stressful situations that change the symptoms?
- Patient
Deadlines definitely make it worse. I also drink about four cups of coffee a day. I haven't traveled recently or taken antibiotics.
- Doctor
Have you tried changing what you eat or taking anything for it?
- Patient
I skip breakfast before meetings and sometimes take an over-the-counter diarrhea medicine. It helps a little.
- Doctor
Do you have any other medical conditions, and what regular medicines or supplements do you take?
- Patient
I have anxiety and take sertraline, fifty milligrams a day. That's all.
- Doctor
Any medicine allergies? And do you smoke, vape, or drink alcohol?
- Patient
No known allergies. I vape socially and drink a couple of beers on weekends.
- Doctor
Does anyone in your family have inflammatory bowel disease, celiac disease, or bowel cancer?
- Patient
An older cousin has Crohn's disease. That's what has me worried.
- Doctor
How is this affecting you day to day, and what were you hoping we could help with?
- Patient
I'm afraid of getting urgent diarrhea in front of clients. I want to know it isn't Crohn's and find a way to control it.
- Doctor
Let me check that I have the story right. For fourteen months you have had lower abdominal cramps and loose stools on three or four days a week. The pain improves after a bowel movement, and stress and coffee seem to worsen it. You have bloating, but no nighttime diarrhea, bleeding, fever, or unplanned weight loss. Your main concern is Crohn's disease and the effect on client meetings. Is there anything important I missed?
- Patient
No, that's exactly it.
- Doctor
Thank you. We'll examine you and decide which focused tests are appropriate before we talk through the possible causes and options together.
- Patient
That sounds good.
Flow at a glance
The route through the history
- Let the patient describe the pattern
- Connect pain with bowel movements
- Characterize stool and associated symptoms
- Screen for alarm features
- Explore triggers and self-treatment
- Ask about family history and impact
- Summarize and verify
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Editorial record
Tied to one reviewed case
This model uses a fictional Bedside English case as its source. The page and pre-generated WAV audio are checked against the same transcript and source-case fingerprints.
Editorial update: