skip to main content

MASLD Treatment — ESEGH MCQ

Instant feedback + full explanation. One question, done properly.

HardGastroenterologyMASLD TreatmentESEGH

A patient taking olmesartan has chronic diarrhoea, weight loss and subtotal villous atrophy. Coeliac serology and HLA-DQ2/DQ8 are negative, and there is no infection. What is the next therapeutic test?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: D — Withdraw olmesartan and reassess the enteropathy

Olmesartan can cause a severe coeliac-like enteropathy with villous atrophy, often after prolonged exposure. Negative coeliac genetics makes coeliac disease very unlikely; drug withdrawal is both therapeutic and diagnostically informative before immunosuppression is considered.

Reference: BSG guideline for investigation of chronic diarrhoea in adults (Current BSG guideline, accessed 30 July 2026): https://www.bsg.org.uk/clinical-resource/bsg-guidelines-for-the-investigation-of-chronic-diarrhoea-in-adults; BSG guideline on diagnosis and management of adult coeliac disease (Published 2026): https://www.bsg.org.uk/clinical-resource/BSG-Guidelines-Adult-Coeliac-Disease