16 Questions
Which of the following statements about combination therapies for constipation is correct?
They target different mechanisms responsible for different symptoms in the same patient.
Which of the following is an example of a combination therapy for constipation?
Prescribing a bulk-forming laxative and a secretory agent like prucalopride or lubiprostone.
What is the main reason stated in the text for using combination therapies in the treatment of constipation?
To address the complexity and heterogeneity of constipation.
Which of the following statements about constipation is true?
Patients with constipation may have different symptom complexes, such as predominant or exclusively irritable bowel syndrome (IBS).
Which of the following is NOT mentioned in the text as a potential cause of constipation?
Poor dietary habits.
Based on the information in the text, which of the following statements is true?
Anorectal manometry followed by a prokinetic agent and biofeedback therapy is an example of a combination treatment.
What is the rationale for combining different types of laxatives in treating constipation?
To address the single-dimensional nature of constipation
Why might patients with slow transit colon and pelvic floor dysfunction not respond well to a bulk or osmotic laxative alone?
Because they require a stimulant laxative for better effectiveness
Why is fiber often recommended as the first line treatment for constipation despite its limited efficacy?
Because it directly targets the underlying pathophysiology
Which combination treatment is NOT effective due to its exacerbation of bloating and flatulence symptoms?
Lactulose and senna
What adverse effects have been associated with stimulant laxatives?
Damage to enteric nerves and melanosis coli
Which oral stimulant laxatives are commonly used in Europe?
Sodium picosulphate and sennosides
In which patient group has combining a stimulant laxative with a colonic prokinetic agent been found effective?
Patients with irritable bowel syndrome and slow transit constipation
What did the CHESS trial compare in elderly patients with chronic constipation?
PEG with placebo or ispaghula husk
What has been demonstrated through Phase III trials by the tegaserod consortium?
The effectiveness of tegaserod and PEG combination for IBS-C and chronic constipation symptoms relief
Why do the authors caution against using unlicensed medications for constipation?
To prevent potential drug toxicity and interactions
Explore the use of combination therapies in the treatment of constipation, considering the complexity and heterogeneity of the condition. Learn about different mechanisms responsible for various symptoms in patients, and how modern medicine incorporates techniques like anorectal manometry, prokinetic agents, and biofeedback therapy.
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