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Irritable Bowel Syndrome — UKMLA MCQ

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MediumGastroenterologyIrritable Bowel SyndromeUKMLAMRCGP AKTMRCP Part 1

A 34-year-old woman presents with chronic abdominal pain and altered bowel habits (diarrhoea and constipation intermittently). No red flag signs are found. According to NICE, which of the following is recommended first-line to manage IBS symptoms?

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Correct answer: D — Psyllium (ispaghula) as a soluble fibre supplement

NICE recommends offering a trial of soluble fibre (e.g., ispaghula) to help with bowel habit irregularities in IBS. A low FODMAP diet can be considered under dietitian guidance if first-line measures fail. Loperamide is used primarily for diarrhoea-predominant IBS. Tricyclic antidepressants are typically considered after simpler measures. An elimination diet requires specialist input.

Reference: NICE Irritable Bowel Syndrome Guideline