A woman has severe IBS and takes hyoscyamine sulfate (Levsin), simethicone (Phazyme), and a TCA. She reports having continued severe diarrhea. The primary care NP should:
a. order diphenoxylate (Lomotil).
b. prescribe alosetron after ruling out pregnancy.
c. refer her to a gastroenterologist for endoscopy.
d. increase the fiber in her diet to 30 g per day.
C
Alosetron is given only to women with severe chronic diarrhea-predominant IBS and only after anatomic or biochemical abnormalities of the GI tract have been excluded. Because this woman's symptoms are persistent and severe, diphenoxylate and increased dietary fiber are not indicated.
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True False