Intermittent Diarrhea in Medicine / Internal Medicine — 56yo Man | Gastroenterology | SMLE Q#18362
SMLE Question #18362
Medicine / Internal Medicine
Gastroenterology
Objective: OBJ-IBS-INIT-MGMT
Last updated: February 2026
A 56-year-old man has 6 months of recurrent crampy lower abdominal pain with intermittent diarrhea. Symptoms worsen with stress and often occur after meals. The pain improves after defecation. He denies fever, weight loss, nocturnal symptoms, hematochezia, or recent travel. Examination shows mild diffuse abdominal tenderness without peritoneal signs. Colonoscopy was normal, and stool testing for infectious pathogens was negative. What is the most appropriate initial dietary recommendation?
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