Managing Chronic Constipation and IBS with Constipation: New Evidence of Overlap, Distinctions, and Improved Treatment Strategies
Release Date: July 25, 2014
Last Reviewed: July 10, 2014
Expiration Date: July 25, 2015
Time to Complete Activity:  1.0 hour

*This activity expired for credit on July 25, 2015 and is no longer available for credit
William D. Chey, MD (Chair)
Professor of Medicine
Director, GI Physiology Laboratory
Co-director, Michigan Bowel Control Program
University of Michigan Health System
Ann Arbor, MI
Lin Chang, MD
Professor of Medicine
Co-Director, Oppenheimer Family Center for Neurobiology of Stress
Division of Digestive Diseases
David Geffen School of Medicine at UCLA
Los Angeles, CA
Brian E. Lacy, MD, PhD
Professor of Medicine
Division of Gastroenterology and Hepatology
Dartmouth–Hitchcock Medical Center
Lebanon, NH 
Target Audience
This activity has been designed to address the educational needs of physicians specializing in gastroenterology and other healthcare providers including Nurse Practitioners (NPs), and Physician Assistants (PAs) who manage and treat patients with CC and IBS-C.
Statement of Need
Effective management of chronic constipation (CC) and irritable bowel syndrome (IBS)-C involves a comprehensive strategy that includes a dynamic patient–provider relationship and a team approach among GI specialists, primary care practitioners, and allied healthcare professionals, as well as dietary changes, targeted pharmacotherapy; behavioral and psychosocial treatment; patient education; and ongoing monitoring and reassurance. This enduring activity will review the multitude of therapies available—and the clinical data supporting their use in the treatment of CC and IBS-C. Most importantly, this educational activity will describe sound, evidence-based strategies gastroenterologists can use to safely incorporate novel therapies and strategies into individualized treatment plans that acknowledge the heterogeneous nature of CC and IBS-C—and the patients they affect. Taken together, these measures should improve patient care and satisfaction and reduce the burden of disease.
Learning Objectives
Upon proper completion of this activity, participants should be better able to:
  • Describe the impact and prevalence of CC and IBS-C
  • Discuss current evidence-based approaches to accurately characterize CC and IBS-C in order to differentiate them from other medical conditions that present with similar symptoms
  • Formulate evidence-based treatment plans for patients with CC and IBS-C based on ongoing assessment of symptomatology
Table of Contents
  • Incidence and Impact of CC and IBS-C
  • CC and IBS-C: 1 Disease or 2?
  • Individualized Management of Patients with IBS-C
  • Individualized Management of Patients with CC
Physician Accreditation Statement
Paradigm Medical Communications, LLC is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
Physician Credit Designation Statement  
Paradigm Medical Communications, LLC designates this enduring material for a maximum of 1.0 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Physician Assistant Continuing Education
AAPA accepts certificates of participation for educational activities certified for AMA PRA Category 1 Credit™ from organizations accredited by ACCME or a recognized state medical society. Physician Assistants may receive a maximum of 1.0 hour of Category 1 credit for completing this program.
Nurse Practitioner Continuing Education

Global Education Group is approved as a provider of nurse practitioner continuing education by the American Association of Nurse Practitioners: AANP Provider Number 1101021.
This program has been approved for 1.0 contact hour of continuing education (which includes .50 hours of pharmacology).
This program was planned in accordance with AANP CE Standards and Policies and AANP Commercial Support Standard.
Disclosure of Commercial Support
This activity is supported by educational grants from Forest Research Institute, a subsidiary of Forest Laboratories, Inc., and Ironwood Pharmaceuticals; and Takeda Pharmaceuticals International, Inc., U.S. Region and Sucampo.
Instructions for Participation
To receive a CE certificate of participation, participants should:
  • Follow instructions to register or log in with your professional information and complete the pretest.
  • View the online activity in its entirety.
  • Complete and submit the online posttest and evaluation. You must answer 70% of the posttest questions correctly to earn credit. You will have unlimited opportunities to successfully complete the posttest.
  • A certificate of participation will be available for download/printing immediately following your successful completion of the posttest and evaluation.
There is no fee required for participation in this activity.

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iOS Safari 4 or higher, Android 2.3 or higher, IE Mobile 10 or higher
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Disclosure of Conflicts of Interest
Paradigm and Global Education Group (Global) require instructors, planners, managers, and other individuals and their spouse/life partner who are in a position to control the content of this activity to disclose any real or apparent conflict of interest they may have as related to the content of this activity. All identified conflicts of interest are thoroughly vetted by Global for fair balance, scientific objectivity of studies mentioned in the materials or used as the basis for content, and appropriateness of patient care recommendations.
The faculty reported the following financial relationships or relationships to products or devices they or their spouse/life partner have with commercial interests related to the content of this CME activity:
Name of Faculty or Presenter
Reported Financial Relationship
William D. Chey, MD (Chair)
Consultant: AstraZeneca; Forest Laboratories, Inc; Ironwood Pharmaceuticals; Perrigo Company; Prometheus Laboratories Inc; Purdue Pharma LP; Salix Pharmaceuticals, Inc; Sandhill Scientific; Takeda Pharmaceutical Company Limited
Contracted Research: Ironwood Pharmaceuticals; Nestle; Perrigo Company; Prometheus Laboratories Inc
Lin Chang, MD
Consultant: Entera Health, Inc; Ironwood Pharmaceuticals
Contracted Research: Ironwood Pharmaceuticals; Lexicon Pharmaceuticals, Inc; Salix Pharmaceuticals, Inc; Tioga Pharmaceuticals, Inc
Brian E. Lacy, MD, PhD
Consultant: Forest Laboratories, Inc; Ironwood Pharmaceuticals; Prometheus Laboratories Inc; Takeda Pharmaceutical Company Limited
The planners and managers reported the following financial relationships or relationships to products or devices they or their spouse/life partner have with commercial interests related to the content of this CME activity:
Name of Planner or Manager
Reported Financial Relationship
Ashley Marostica, RN, MSN
Nothing to disclose
Amanda Glazar, PhD
Nothing to disclose
Kristen Delisi, CRNP
Nothing to disclose
Paradigm Medical Communications, LLC staff members have no financial relationships to disclose.
Independent peer reviewer has no financial relationships to disclose.
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Paradigm Medical Communications, LLC and Global have implemented a system to resolve conflicts of interest for each CME activity to help ensure content objectivity, independence, fair balance, and that the content is aligned with the interest of the public. Conflicts, if any, are resolved through one or more processes. All CME content in this activity was independently reviewed to ensure that it is free of commercial bias, scientifically rigorous, aligned with the public interest, and compliant with all regulatory guidance and the ACCME’s Standards for Commercial Support of Continuing Medical Education.
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