A 34-year-old woman has had diarrhea for 1 week. What factor suggests inflammatory bowel disease?

The presence of bloody nocturnal diarrhea is a strong indicator of inflammatory bowel disease (IBD), such as Crohn's disease or ulcerative colitis. Inflammatory bowel disease is characterized by chronic inflammation of the gastrointestinal tract, which can lead to ulcerations, bleeding, and significant disruptions in bowel function. The occurrence of bloody diarrhea, particularly during the night, suggests a more severe underlying condition, as normal gastrointestinal disturbances like irritable bowel syndrome (IBS) typically do not involve blood or nocturnal symptoms.

This contrasting symptom profile enhances the recognition of IBD. Diarrhea associated with IBD can often be accompanied by other systemic symptoms such as weight loss, abdominal pain, and fever, indicating that there is ongoing inflammation. The nocturnal aspect of the diarrhea signals that the condition is likely not related to dietary triggers, which are more typical in functional gastrointestinal disorders like IBS.

The other factors, while they may suggest some degree of gastrointestinal dysfunction, do not specifically pinpoint IBD in the same way. Elevated white blood cell counts could indicate infection or inflammation but are not specific to IBD. A family history of IBS may suggest a propensity for functional gastrointestinal disorders but does not imply IBD. Symptoms like fatigue and weakness, along with fever, can