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Elizabeth is 47 years old and complains of feeling bloated for the last few months. Her bowel habit is unchanged, and she denies any blood in the stool. She tells you she has always suffered on and off with ‘irritable bowel’, although you can see there is no formal diagnosis of this on her record. She tells you her bloating is sometimes related to having too much bread, but no other foods are clear triggers.

Her weight is stable and despite feeling bloated on several days of the week, her appetite remains good. She has no abdominal pain or urinary symptoms. She is not sexually active and denies any intermenstrual bleeding. Her abdominal examination is normal today.

What is the next most appropriate action to investigate her symptoms?

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