A 41-year-old woman visited the gastroenterology clinic with an eight-month history of bloating and abdominal discomfort, relieving slightly after a bowel movement. She had no complaints of nausea or vomiting, while she reported having constipation for most of her adult life. Upon further questioning, she revealed to have a history of dysmenorrhea.
Colonoscopy was performed one year before (because her father was diagnosed with colon cancer); however, the result was normal. Medical/surgical/medication history: Not significant Laboratory tests findings: Hemoglobin: 10.7 g/dL Mean corpuscular volume (MCV): 76 fL Ferritin: 6 μg/L Tissue transglutaminase (tTG) IgA: Normal Which one of the following is the next best step? Treatment initiation with dicyclomine Advice small bowel biopsies Repeat colonoscopy Measure gliadin antibodies Perform intestinal transit studies *This case is from…
