Review Question - QID 210462

A 26-year-old student arrives at student health services for persistent diarrhea. She states that for the past 2 months, she has had foul-smelling diarrhea and abdominal cramping. She also reports increased bloating, flatulence, and an unintentional 4 lb weight loss. Prior to 2 months ago, she had never felt these symptoms before. She denies other extra-gastrointestinal symptoms. The patient is an avid hiker and says her symptoms have caused her to miss recent camping trips. The patient has tried to add more fiber to her diet without relief. She feels her symptoms worsen with milk or cheese. Her medical history is insignificant and she takes no medications. She drinks whiskey socially but denies smoking tobacco or using any illicit drugs. She is sexually active with her boyfriend of 2 years. She went to Mexico 6 months ago and her last multi-day backpacking trek was about 3 months ago in Vermont. Her temperature is 98.6°F (37°C), blood pressure is 110/70 mmHg, pulse is 76/min, and respirations are 15/min. Physical examination is unremarkable. A stool sample is negative for fecal occult blood. Which of the following is an associated adverse effect of the most appropriate treatment for this patient’s symptoms?