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Dietary interventions form a cornerstone of IBS management: General dietary advice : Regular meal patterns, adequate hydration (8 glasses of fluid daily), limiting caffeine and alcohol, and reducing fatty or spicy foods Fibre modification : Soluble fibre (such as ispaghula/psyllium) may help, whilst insoluble fibre (bran) can worsen symptoms Low FODMAP diet : A structured elimination and reintroduction protocol, supervised by a registered dietitian, can identify specific carbohydrate triggers Probiotics : Certain strains may provide benefit, though evidence varies Pharmacological treatments are tailored to predominant symptoms: For IBS-D : Loperamide (antimotility agent) for diarrhoea

3c) but the rate of new-onset macroalbuminuria was greater in the SGLT2i than in the GLP-1RA group (HR 2.03

Ben Greenfield: Thank you