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MMI Scenario 30
Mrs Patel, a 32-year-old woman, comes to the dispensary asking to talk to a pharmacist. She has recently received a prescription for Colpermin from her GP for irritable bowel syndrome. She says that they gave her terrible indigestion and she wants to know if you can sell her anything stronger for the indigestion. She feels her problems are just getting worse as she also has constipation, stomach cramps and bloating. What advice would you give her?
Example Answer
IBS: Establish with the patient her understanding of her condition and the common symptoms that patients experience who have IBS. Include in the discussion that patients with IBS often experience abdominal pain, altered bowel habit and bloating.
Red Flags: Rule out any symptoms that would require referral such as sudden weight loss, family history of bowel cancer, rectal bleeding etc.
Lifestyle Advice: Give the patient advice on how to minimise her symptoms of IBS. Include advice such as trying to lower stress, exclude foods that may aggravate her IBS (FODMAP Diet), limit alcohol and caffeine intake, increase fibre intake to relieve constipation and to keep active.
Alternative Management: Consider alternative treatments that may also work such as anti-spasmodics (hyoscine butylbromide), mebeverine or alverine. It may also be appropriate to discuss the possible use of laxatives that may help ease her constipation, whilst not provoking cramping or bloating.
Red Flags: Rule out any symptoms that would require referral such as sudden weight loss, family history of bowel cancer, rectal bleeding etc.
Lifestyle Advice: Give the patient advice on how to minimise her symptoms of IBS. Include advice such as trying to lower stress, exclude foods that may aggravate her IBS (FODMAP Diet), limit alcohol and caffeine intake, increase fibre intake to relieve constipation and to keep active.
Alternative Management: Consider alternative treatments that may also work such as anti-spasmodics (hyoscine butylbromide), mebeverine or alverine. It may also be appropriate to discuss the possible use of laxatives that may help ease her constipation, whilst not provoking cramping or bloating.