Facilitator notes

Facilitator, please role-play this patient and allow the student/team to collect a focused history. The key elements are reported here, provide generic information when there is no applicable answer below.
After the role-play, provide the History handout to the player.

Ashley Monroe, 17 years old, non-Aboriginal or Torres Strait Islander.

Opening line: “I’ve been having diarrhoea for weeks and I’m sick of it!”

You have been having 3-4 loose stools most days for the last 4 weeks. They range in consistency: sometimes they are entirely water-thin, other times they resemble a thick soup. There is no blood or mucus in the stools. You were mostly regular prior to this, but started noticing your bowel movements becoming looser and looser over the past 3 months.

You have also intermittent abdominal pain and bloating. The pain is an episodic, 3/10 severity, generalised ache around the centre of your tummy. You have not noticed any exacerbating or relieving factors.

You have lost 2kg in the last month despite no diet changes, and you didn’t want to lose any weight.

Past medical history

You have no medical conditions and take no regular medications. You had appendicitis 4 years ago and needed keyhole surgery. There were no surgical complications. You have no allergies.

Your mum has had type 1 diabetes since she was a child. Your older sister was recently diagnosed with Hashimoto’s thyroiditis. You don’t know your father.

You are not aware of any history of inflammatory bowel disease or irritable bowel syndrome in your family.

Lifestyle and social history

You live with your mum and older sister Sarah in Newcastle. You are in year 11 and enjoying your studies.

You have not travelled overseas or interstate recently. You do not smoke cigarettes, drink alcohol or take recreational drugs. You eat a balanced diet.

An average day consists of Weetbix for breakfast; chicken and salad wraps for lunch, plus an apple or a banana. You eat vegetables and meat for dinner, plus a snack after dinner. You play netball on the weekends.