Reviews for Primary Care - Fall 2007 - (Page 12) CME-CERTIFIED ARTICLE TREATMENT UPDATE Fresh Perspectives in Chronic Constipation and Other Functional Bowel Disorders Brooks D. Cash, MD, FACG, FACP,* Eugene Chang, MD,† Nicholas J. Talley, MD, PhD, FRACP, FRCP, FACP,‡ Arnold Wald, MD, MACG, AGAF§ *Gastroenterology Division and Colon Health Initiative, National Naval Medical Center, Uniformed Services University of the Health Sciences, Bethesda, MD; †University of Chicago, Chicago, IL; ‡Mayo Clinic College of Medicine, Rochester, MN; §University of Wisconsin School of Medicine and Public Health, Madison, WI Functional bowel disorders (FBDs) such as chronic constipation and irritable bowel syndrome-constipation predominant (IBS-C) often share symptoms, but thanks to advances such as the Rome III criteria, diagnosis of these conditions in the absence of alarm features can be relatively straightforward. Empiric treatment is recommended for most patients, with diagnostic testing reserved for those with alarm symptoms. Most current therapies for constipation are indicated for patients with occasional symptoms, with only lubiprostone and tegaserod (restricted) indicated for chronic constipation. Therapies for IBS-C also are limited. However, ongoing research provides promise for improved outcomes in patients with FBDs. © 2007 MedReviews, LLC unctional bowel disorders (FBDs) are among the most common of the functional gastrointestinal disorders (FGIDs) and include irritable bowel syndrome (IBS), functional constipation, functional bloating, functional diarrhea, and unspecified FBDs.1,2 FBDs are characterized by a combination of chronic and/or recurrent lower gastrointestinal symptoms that are not explained by structural or biochemical abnormalities and that cannot be diagnosed through endoscopic, radiologic, or laboratory studies.1,3 FBDs are chronic, defined by the F 12 VOL. 1 NO. 1 2007 REVIEWS FOR PRIMARY CARE
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