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IBS-C — ESEGH MCQ

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HardGastroenterologyIBS-CESEGH

A patient with IBS-C has had constipation for 18 months despite maximum tolerated doses of an osmotic laxative and a stimulant laxative. There are no alarm features. Which next prescription and review plan matches NICE?

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Reveal the answer and explanation

Correct answer: C — Start linaclotide and assess response after three months

C is correct. NICE considers linaclotide after optimal or maximum tolerated laxatives from different classes have failed and constipation has lasted at least 12 months, then reviews at three months. A uses a discouraged laxative without review. B worsens constipation. D does not reflect the stated criteria. E is constipating and unsafe.

Reference: NICE CG61: irritable bowel syndrome in adults: https://www.nice.org.uk/guidance/cg61/chapter/recommendations