Quick Hits

Irritable bowel syndrome (IBS) is a complex, multifactorial disorder characterized by chronic or recurrent abdominal pain associated with altered bowel habits. My general approach is to identify the predominant or most bothersome symptoms and the most likely pathophysiologic mechanisms underlying these symptoms. Then I target treatment toward these predominant symptoms and mechanisms. Validating symptoms, building […]

Quick Hits

1. Why do I need to know about defecatory disorders?  Defecation requires increased rectal pressure coordinated with relaxation of the anal sphincter and pelvic floor. Some patients with chronic constipation have defecatory disorders (DDs). In contrast to normal or isolated slow transit constipation, these should be treated with pelvic floor biofeedback therapy rather than laxatives.1,2 […]