Question 1

A patient reports a decrease in the frequency of stools and asks about treatment for constipation. Which findings are part of the Rome IV criteria for diagnosing constipation? (Select all that apply.)&#10;A) Feeling of incomplete evacuation&#10;B) Fewer than 5 stools per week&#10;C) Hard or lumpy stools&#10;D) Presence of irritable bowel syndrome&#10;E) Symptoms present for 3 months

Accepted Answer

The Rome IV criteria for diagnosing constipation include a feeling of incomplete evacuation, hard or lumpy stools, and symptoms present for at least 3 months.

Question 2

A patient diagnosed with chronic constipation uses polyethylene glycol and reports increased abdominal discomfort with nausea and vomiting. What is the initial action by the provider?&#10;A) Increase the dose of polyethylene glycol&#10;B) Obtain radiographic abdominal studies&#10;C) Perform a stool culture and occult blood&#10;D) Refer to a specialist for colonoscopy

Accepted Answer

The symptoms of increased abdominal discomfort with nausea and vomiting may indicate a potential obstruction, so obtaining radiographic abdominal studies should be the initial action to assess for this possibility. Increasing the dose of polyethylene glycol or performing stool culture and occult blood may not be appropriate until the cause of the symptoms is determined. Referring to a specialist for colonoscopy may be necessary later, but it is not the initial action.

Question 3

A patient has recurrent constipation which improves with laxative use but returns when laxatives are discontinued. Which pharmacologic treatment will the provider recommend for long-term management?&#10;A) Bisacodyl&#10;B) Docusate sodium&#10;C) Methylcellulose&#10;D) Mineral oil

Accepted Answer

Methylcellulose is a bulk-forming laxative that can be used for long-term management of constipation. Unlike other laxatives such as Bisacodyl and Mineral oil, it does not cause dependence or disrupt electrolyte balance. Docusate sodium is a stool softener and not as effective in treating chronic constipation compared to bulk-forming agents like Methylcellulose.

Deck 113: Constipation