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Anthony J. Lembo, MD, Discussant

JAMA. 2006;295:925-933.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

INTRODUCTION

DR REYNOLDS: Mrs G is a 54-year-old woman with abdominal pain and discomfort associated with constipation. Her bowel difficulties began in early childhood when she did not feel comfortable moving her bowels in public restrooms. Her symptoms diminished during her teenage years but began again in her 20s; over the past several years her constipation has become more problematic.

She has experienced bloating, generalized abdominal discomfort, and an inability to eat large meals. She experiences mild lower abdominal cramps while moving her bowels; she does not have any diarrhea. Mrs G has used many different over-the-counter laxatives including osmotic and stimulant laxatives; those products have typically improved her bowel regularity for a short time, but with prolonged use have stopped working. After she was diagnosed with osteoporosis several years ago, Mrs G, who had always been very small, began trying . . . [Full Text of this Article]

MRS G: HER VIEW

AT THE CROSSROADS: QUESTIONS FOR DR LEMBO

Initial Evaluation

Possible Causes of C-IBS

Treatment of C-IBS

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RECOMMENDATIONS FOR MRS G

QUESTIONS AND DISCUSSION

AUTHOR INFORMATION

Author Affiliation: Dr Lembo is Instructor in Medicine at Harvard Medical School, and Director, Gastrointestinal Motility Center, Beth Israel Deaconess Medical Center, Boston, Mass.

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