A nurse is providing dietary teaching to a client who has a new diagnosis of irritable bowel syndrome. Which of the following recommendations should the nurse include?

Choice A reason: Fructose corn syrup exacerbates irritable bowel syndrome (IBS) symptoms, as fermentable carbohydrates cause gas and bloating. IBS involves altered gut motility and microbiota, and high-fructose foods trigger visceral hypersensitivity, worsening abdominal pain and discomfort, making this an inappropriate dietary recommendation. Choice B reason: Gluten-rich foods may worsen IBS in clients with non-celiac gluten sensitivity, causing bloating and diarrhea. Gluten disrupts gut motility in susceptible individuals, exacerbating IBS symptoms. Avoiding gluten is often advised, making increased intake counterproductive to managing IBS effectively. Choice C reason: Milk products, containing lactose, worsen IBS in lactose-intolerant clients, causing bloating and diarrhea. Fermentable carbohydrates exacerbate gut dysmotility and visceral hypersensitivity, common in IBS, making increased dairy intake inappropriate for symptom management and dietary control in affected clients. Choice D reason: Bran fiber, a soluble fiber, regulates bowel movements in IBS by adding bulk and stabilizing colonic transit. It reduces diarrhea and constipation, supporting microbiota health and alleviating symptoms. This evidence-based recommendation aligns with dietary management to improve gut function in IBS clients.