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IBS-C pharmacotherapy — GPhC CRA MCQ

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HardGI TherapeuticsIBS-C pharmacotherapyGPhC CRA

A 62-year-old woman with irritable bowel syndrome (IBS-C) has tried dietary fibre modification, regular exercise, and antispasmodics without adequate relief of her constipation. She asks about prescription options. According to NICE, which is the most appropriate next pharmacological step?

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Correct answer: B — Linaclotide 290 micrograms once daily

NICE recommends linaclotide for IBS with constipation (IBS-C) that has not responded to first-line treatments including dietary measures, exercise, and laxatives tried for at least 12 months. Linaclotide is a guanylate cyclase-C agonist that increases intestinal fluid secretion and transit. Prucalopride is licensed for chronic idiopathic constipation rather than IBS-C specifically. Loperamide would worsen constipation.

Reference: NICE CG61 IBS; BNF