Combination Therapies for Constipation Treatment
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Questions and Answers

Which of the following statements about combination therapies for constipation is correct?

  • They are a recent development in modern medicine.
  • They target different mechanisms responsible for different symptoms in the same patient. (correct)
  • They are universally effective for all types of constipation.
  • They are only used as a last resort when single therapies fail.
  • 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. (correct)
  • Recommending increased fluid intake and regular exercise.
  • Prescribing a prokinetic agent and undergoing surgery.
  • Administering a stimulant laxative and an enema.
  • What is the main reason stated in the text for using combination therapies in the treatment of constipation?

  • To reduce the overall cost of treatment.
  • To address the complexity and heterogeneity of constipation. (correct)
  • To improve patient compliance with treatment regimens.
  • To reduce the risk of adverse effects associated with single therapies.
  • Which of the following statements about constipation is true?

    <p>Patients with constipation may have different symptom complexes, such as predominant or exclusively irritable bowel syndrome (IBS).</p> Signup and view all the answers

    Which of the following is NOT mentioned in the text as a potential cause of constipation?

    <p>Poor dietary habits.</p> Signup and view all the answers

    Based on the information in the text, which of the following statements is true?

    <p>Anorectal manometry followed by a prokinetic agent and biofeedback therapy is an example of a combination treatment.</p> Signup and view all the answers

    What is the rationale for combining different types of laxatives in treating constipation?

    <p>To address the single-dimensional nature of constipation</p> Signup and view all the answers

    Why might patients with slow transit colon and pelvic floor dysfunction not respond well to a bulk or osmotic laxative alone?

    <p>Because they require a stimulant laxative for better effectiveness</p> Signup and view all the answers

    Why is fiber often recommended as the first line treatment for constipation despite its limited efficacy?

    <p>Because it directly targets the underlying pathophysiology</p> Signup and view all the answers

    Which combination treatment is NOT effective due to its exacerbation of bloating and flatulence symptoms?

    <p>Lactulose and senna</p> Signup and view all the answers

    What adverse effects have been associated with stimulant laxatives?

    <p>Damage to enteric nerves and melanosis coli</p> Signup and view all the answers

    Which oral stimulant laxatives are commonly used in Europe?

    <p>Sodium picosulphate and sennosides</p> Signup and view all the answers

    In which patient group has combining a stimulant laxative with a colonic prokinetic agent been found effective?

    <p>Patients with irritable bowel syndrome and slow transit constipation</p> Signup and view all the answers

    What did the CHESS trial compare in elderly patients with chronic constipation?

    <p>PEG with placebo or ispaghula husk</p> Signup and view all the answers

    What has been demonstrated through Phase III trials by the tegaserod consortium?

    <p>The effectiveness of tegaserod and PEG combination for IBS-C and chronic constipation symptoms relief</p> Signup and view all the answers

    Why do the authors caution against using unlicensed medications for constipation?

    <p>To prevent potential drug toxicity and interactions</p> Signup and view all the answers

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