Primary Care Network

Chronic Constipation and IBS-C: A Primary Guide to Treatment Today

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Post Test

Please answer the following questions by selecting the response you feel is correct for each question. Completion of this post-test will assist Primary Care Network in the measurement of educational outcomes. Thank you.

1. According to the American College of Gastroenterology Chronic Constipation Task Force, “red flag” alarm signs or symptoms indicating the need for a colonoscopy include all of the following with the exception of:

A. New-onset constipation in an elderly patient

B. Severe, persistent constipation that is unresponsive to empiric treatment

C. Weight gain of 10 or more pounds

D. Family history of colon cancer or inflammatory bowel disease

E. Hematochezia

F. Positive fecal occult blood test

G. Unexplained anemia

2. Which of the following is indicated for the treatment of chronic idiopathic constipation?

A. Bulking agents (e.g.., psyllium)

B. Stool softeners (e.g.., docusate sodium and docusate calcium)

C. Osmotic laxatives (e.g.., PEG 3350, lactulose, and milk of magnesia)

D. Stimulant laxatives (e.g., senna or bisacodyl)

E. Chloride channel activators (e.g., lubiprostone)

3. What symptom differentiates IBS-C and Chronic Constipation?

A. Straining

B. Abdominal pain

C. Hard and lumpy stool

D. Bloating

4. The ACG taskforce recommends _________ after a targeted physical and DRE when there are no alarm signs or symptoms present in a patient with constipation.

A. Blood tests

B. Empiric therapy

C. Colonoscopy

D. Balloon Expulsion

5. Fill in the blanks: Lubiprostone is a ____________ that is ____________.

A. 5-HT4 receptor agonist; systemic

B. 5-HT4 receptor agonist; nonsystemic

C. Chloride channel activator; systemic

D. Chloride channel activator; nonsystemic

6. _________is a simple diagnostic tool for the assessment of fecal impactions, anal strictures or rectal masses. It can also provide information about anal sphincter tone/strength, puborectalis muscle tenderness/spasm or the ability of patients to open rectal outlet during simulated defecation.

A. Patient diary of bowel habits

B. A digital rectal exam

C. Anorectal manometry

D. Balloon expulsion testing

7. A diagnosis of IBS-C can be confidently made by:

A. Detecting biomarkers for IBS-C

B. Excluding other gastrointestinal disorders first

C. Applying symptom-based criteria while excluding alarm features or “red flags”