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Case Study: Irritable Bowel Syndrome "I feel all bloated and I really have to strain to have a bowel movement. I have been really uncomfortable for the past 4 weeks. Most recently, I added Metamucil tablets to the docusate I was already taking because someone in the past told me that I would probably be able to tolerate the tablets better than Metamucil powder. I haven't seen much improvement in the 8 weeks that I have been using them, plus it is hard to remember to take them three times a day. I have tried to live with this but I really think I need to try something else. Is there anything you can give me?" HPI Jane Hoffman is a 28-year-old woman who presents to her PCP with the chief complaint of a 7-month history of hard pellet-like stools and difficulty passing stools. She has been able to tolerate the minimal symptoms until about 8 months ago when she began to notice some bloating and a decrease in the number of bowel movements per week. She states that she now constantly feels bloated and has taken to wearing loose-fitting clothing because she cannot tolerate anything tight around her abdomen.
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