Bloating and bowel change — CCE clinical encounter

Objectives

1. Make the positive Rome IV diagnosis from history alone, naming supportive features. ^[18]
2. Order the limited mandatory battery — FBC, CRP/ESR, coeliac serology ± faecal calprotectin — and explain why colonoscopy is not indicated. ^{[18] [2]}
3. Address the family-history fear honestly using red-flag logic rather than scope-for-reassurance. ^[18]
4. Correct the failed elimination experiments (dairy, gluten) and set up evidence-based dietary management under supervision. ^{[10] [18]}
5. Start subtype-based therapy (soluble fibre first) and book measurement-based review with explicit safety-netting. ^{[4] [18]}