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Chapter 21. Constipation, Diarrhea, and Irritable Bowel Syndrome

Student Questions

Select the predominant clinical findings, symptoms, or history that is associated with functional constipation:

A. Hypertension and cholecystitis

B. Infrequent (< 3 times per week) bowel movements and sensation of incomplete defecation

C. Fever and vomiting

D. Family history of colon cancer and unintentional weight loss of more than 10% in 3 months

Answer: B

Option A: Incorrect. Neither the diagnosis of hypertension nor cholecystitis is associated with functional constipation.

Option B: Correct. Functional constipation is diagnosed based upon presence of at least two symptoms, which include infrequent stools and sensation of incomplete evacuation of bowels.

Option C: Incorrect. Fever and vomiting are associated with various conditions but are not criteria for the diagnosis of functional constipation.

Option D: Incorrect. The presence of a family history of colon cancer does not confer the diagnosis of functional constipation. The presence of unintentional weight loss in a patient with constipation is considered an alarm symptom. Its presence does not necessarily indicate the diagnosis of functional constipation.

Which one of the following is consistent with a diagnosis of opioid-induced constipation?

A. Persistent abdominal pain and bloating associated with episodes of mixed bouts of constipation and diarrhea

B. Intermittent passage of hard stools alternating with frequent loose stools

C. Patient perception of bowel-related stress associated with straining during defecation after increasing or initiating opioid therapy

D. Development of hemorrhoids upon change in dosage and route of administration of an opioid product

Answer: C

Option A: Incorrect. These symptoms are more consistent with the diagnosis of IBS-M.

Option B: Incorrect. Loose stools are rarely present in OIC unless the patient takes laxatives.

Option C: Correct. The perception of bowel-related stress occurred after initiation of opioid therapy.

Option D: Incorrect. The development of hemorrhoids is not exclusively associated with initiation of opioid therapy.

Neurologic conditions associated with constipation include all the following except:

A. Laxative abuse

B. Stroke

C. Multiple sclerosis

D. Brain trauma

Answer: A

Option A: Correct. Laxative abuse is not a neurological condition associated with constipation.

Options B, C, and D: Incorrect. ...

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