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Quiz: IBS and Disorders of Gut-Brain Interaction

Test your understanding of Chapter 10. Choose the best answer, then click Show Answer to check.

Question 1

Under the Rome IV criteria for adults, how often must IBS belly pain occur?

  1. Every day, all day, for at least 1 year
  2. At least 3 days a month, if it is not continuous
  3. On average at least 1 day a week in the last 3 months
  4. Only once, if it was severe
Show Answer

The correct answer is C. Rome IV requires recurrent belly pain on average at least 1 day a week in the last 3 months, linked to two or more of the three bowel features, with symptoms starting at least 6 months before diagnosis. Option B describes Rome V (2026), the newer and now current version.

Concept Tested: Rome IV Criteria Bloom's Level: Remember

Question 2

What does the acronym FODMAP refer to?

  1. Short-chain carbohydrates that are poorly absorbed and quickly fermented by gut bacteria
  2. A group of proteins in wheat that trigger celiac disease
  3. Fats that slow down digestion in the stomach
  4. Chemicals made by the brain that control gut movement
Show Answer

The correct answer is A. FODMAP stands for fermentable oligosaccharides, disaccharides, monosaccharides, and polyols: carbohydrates that are poorly absorbed in the small intestine and fermented by bacteria in the colon, producing gas and drawing in water. Option B describes gluten, which is a protein, not a FODMAP.

Concept Tested: FODMAP Bloom's Level: Remember

Question 3

Which of the following is an alarm feature that calls for further medical evaluation in someone with IBS-like symptoms?

  1. Pain that improves after a bowel movement
  2. Bloating after meals
  3. Symptoms that get worse before exams
  4. Blood in the stool
Show Answer

The correct answer is D. Rectal bleeding or bloody stools can signal a structural disease such as IBD and always need evaluation. Option A is actually one of the typical IBS features in the Rome criteria, not a warning sign.

Concept Tested: Alarm Features Bloom's Level: Remember

Question 4

Why do experts now prefer the term "disorders of gut-brain interaction" over "functional gastrointestinal disorders"?

  1. Because new tests can now see damage in the gut in every case of IBS
  2. Because "functional" was often misheard as "fake," while the new term describes the real problem in gut-brain signaling
  3. Because IBS has been shown to be a form of inflammatory bowel disease
  4. Because the condition is caused only by anxiety
Show Answer

The correct answer is B. "Functional" meant the gut looks normal but works differently, yet many people heard it as "imaginary." The new term names the actual problem: how the gut and brain communicate and process signals. Rome V (2026) minimizes the word "functional." Option C is wrong because IBS is not a form of IBD.

Concept Tested: Structural vs Functional Disease Bloom's Level: Understand

Question 5

What is the purpose of the reintroduction phase of the low-FODMAP diet?

  1. To find which specific FODMAP groups trigger a person's symptoms so their long-term diet can be as broad as possible
  2. To prove that the person has celiac disease
  3. To replace the elimination phase, which is optional
  4. To permanently remove all FODMAP foods from the diet
Show Answer

The correct answer is A. The diet is a short elimination followed by adding food groups back one at a time, so people end up avoiding only true triggers. Option D describes the "forever diet" idea, which this chapter grades as Hype.

Concept Tested: Low-FODMAP Diet Bloom's Level: Understand

Question 6

A doctor prescribes a low dose of a tricyclic antidepressant for a teen with IBS. What is the best explanation?

  1. The doctor has decided the teen's IBS is really depression
  2. The medicine kills harmful gut bacteria
  3. At low doses, the medicine acts as a gut-brain neuromodulator that can turn down pain signaling
  4. The medicine is a type of FODMAP
Show Answer

The correct answer is C. In IBS, low-dose tricyclic antidepressants are used as gut-brain neuromodulators to reduce pain and change gut movement, not to treat depression. Option A is the common misunderstanding this chapter corrects.

Concept Tested: Gut-Brain Neuromodulator Bloom's Level: Understand

Question 7

Kai, 20, got food poisoning from a bacterial infection last spring. Since then he has had recurring belly pain linked to bowel movements and loose stools, and his tests show no inflammation. Which concept best fits his situation?

  1. Functional dyspepsia
  2. Ulcerative colitis
  3. Hirschsprung disease
  4. Post-infection IBS
Show Answer

The correct answer is D. IBS that starts after a bout of infectious gastroenteritis is called post-infection IBS. A 2017 meta-analysis found that about 10% of people had IBS 12 months after infectious enteritis. Ulcerative colitis (option B) would show inflammation on tests, and functional dyspepsia (option A) involves upper-belly symptoms like early fullness.

Concept Tested: Post-Infection IBS Bloom's Level: Apply

Question 8

A 30-year-old has had recurring belly pain about 2 days a week for a year. The pain eases after bowel movements and comes with harder, less frequent stools. She has no alarm features, and a doctor confirms the pattern with a careful history and exam. Which approach does the ACG's 2021 guideline suggest?

  1. Order every available test to rule out all other diseases before considering IBS
  2. Make a positive diagnosis of IBS based on the symptom pattern, history, exam, and the absence of alarm features
  3. Tell her the symptoms are caused by stress and need no treatment
  4. Recommend a lifelong gluten-free diet
Show Answer

The correct answer is B. The ACG suggests a positive diagnostic strategy over a strategy of exclusion so people can start treatment sooner. Option A describes the older "diagnosis of exclusion" approach, which can mean years of unnecessary tests, as Sam experienced.

Concept Tested: Positive Diagnosis Strategy Bloom's Level: Apply

Question 9

In a 2021 meta-analysis of 73 IBS drug trials, 27.3% of people given placebo reported overall improvement. What is the most important lesson for judging an IBS treatment claim?

  1. Placebos cure IBS, so medicines are unnecessary
  2. People in IBS trials usually lie about their symptoms
  3. A treatment that helps 27% of people must be effective
  4. A treatment must do better than placebo in a controlled trial, because many people improve without an active treatment
Show Answer

The correct answer is D. Expectations, attention, and natural ups and downs mean many people feel better on placebo, so only a comparison with placebo shows whether a treatment adds a real benefit. Option C ignores this baseline, and option B misunderstands the placebo response, which involves real changes in how symptoms are experienced.

Concept Tested: Placebo Response Bloom's Level: Analyze

Question 10

In a 2026 survey of 1,275 UK adults with self-reported IBS, 59.0% met Rome IV and 70.0% met Rome V. What is the best conclusion?

  1. The criteria version changes who counts as having IBS, so prevalence numbers must say which version they used
  2. IBS became more common between 2016 and 2026
  3. Rome V is more accurate than Rome IV
  4. About 70% of UK adults have IBS
Show Answer

The correct answer is A. The same people were classified differently depending on the rules, which is why this book always writes "by Rome IV criteria" next to research numbers. The survey included only people who already said they had IBS, so option D is wrong, and it can't show which version is more accurate (option C).

Concept Tested: Rome IV Criteria Bloom's Level: Analyze