Battling bloating and pain
Sally, a 32-year-old married woman, presents for management of irritable bowel syndrome (IBS).
She had been experiencing a range of gastrointestinal symptoms such as loose stools, vague generalised abdominal and pelvic pain, discomfort and bloating.
A coeliac antibody serology test was positive but she was not keen to proceed to an endoscopy for a definitive diagnosis with biopsy for coeliac disease. Her symptoms did not improve on a high-fibre diet.
Sally had a history of premenstrual syndrome for many years and had