Which presenting symptom most commonly raises suspicion for IBD in adults?

• A. Chronic diarrhea, abdominal pain, hematochezia, weight loss, fatigue.
• B. Acute cough.
• C. Fever without GI symptoms.
• D. Elevated blood pressure.

Answer: (C)

Chronic gastrointestinal symptoms are the hallmark that raise suspicion for inflammatory bowel disease in adults. When the gut is inflamed, patients most often notice ongoing changes in bowel habits and related symptoms. The most common presentation includes long-standing diarrhea, abdominal discomfort or pain, and fatigue, often accompanied by unintended weight loss and sometimes blood in the stool (hematochezia). These signs point to a persistent intestinal process rather than a transient illness.

Fever without GI symptoms is non-specific and can occur with many infections or other conditions; it doesn’t specifically point to IBD as the initial presenting pattern. Similarly, an acute cough or elevated blood pressure are not typical features that suggest IBD and do not drive suspicion for this disease.

So, the presentation that most commonly prompts clinicians to consider IBD is the pattern of chronic GI symptoms—especially persistent diarrhea with abdominal pain and possibly weight loss and hematochezia—rather than isolated systemic signs.