Large Intestine - Motility

Question 1

Imaging test for bile acid malabsorption?

Abnormal if?

Answer 1

SeHCAT - selenium homocholic acid taurine

Bio acid retention under 15%

Question 2

Rome IV Criteria for the diagnosis of chronic functional constipation?

Answer 2

2+ during 25% of defecations:
-Straining
-Hard stool
-Incomplete evacuation or anal rectal obstruction
-Manual maneuvers to Facilitate evacuation
-Less than three defecations per week
-rare loose stools without laxative

Question 3

Classifications of chronic functional constipation?

Answer 3

• Slow transit constipation
  – functional defecatory disorder
  – normal transit constipation

Question 4

Laxative dependence and less than two defecation per week suggest which type of constipation?

Answer 4

Slow transit constipation

Question 5

Subtypes of functional defecatory disorder?

Answer 5

-Dyssynergic defecation
– inadequate defecatory propulsion

Question 6

Transient internal anal sphincter relaxation in response to rectal distention is called? Its presence excludes this etiology?

Answer 6

Rectoanal inhibitory reflex

Hirshsprung disease

Question 7

Normal balloon expulsion test time?

Answer 7

<1 Minute

Question 8

Sitz marker study outcomes?

Answer 8

• normal under five markers
  – slow transit constipation
  – dyssynergy defecation

Question 9

The study can identify luminal anatomic abnormalities related to constipation?

The study evaluates pelvic floor anatomy?

Answer 9

Barium Defecography

MRI Defecography

Question 10

secretagogues - Increases intestinal fluid secretion by activating chloride channels of enterocytes?

Answer 10

Lubuprostone (Amitiza)

Question 11

secretagogues - Increases intestinal fluid secretion by acting as a guanylate cyclase-C receptor agonist leading to CTFR channel openings?

Answer 11

Linaclotide (Lizness)

Plecanatide (trulance)

Question 12

Ileal bile acid transporter inhibitor that increases frequency of bowel movements through bile acid malabsorption?

Answer 12

Elobixibat

Question 13

Ileal bile acid transporter inhibitor that increases frequency of bowel movements through bile acid malabsorption?

Answer 13

Elobixibat

Question 14

Patients who develop constipation refractory to treatment can try?

Answer 14

Sacral (S3) neuromodulation/Simulator

Question 15

Rome IV IBS Criteria?

Answer 15

2+ of the following for 1 day/week over the past 3 months
-abdominal pain related to defecation
-abdominla pain associated with change in frequency of stool
-abdominal pain associated with change in stool consistency

Question 16

IBS-D medications?

Answer 16

Loperamide
Bile acid sequestrants
Rifaximin
Eluxadoline (viberzi)

Question 17

Eluxadoline (viberzi) Mechanism of action?

contraindicated in patients with?

Answer 17

Mixed opiods receptor modulator

sphincter of oddi dysfunction, hustory of pancreatitis, alcohol abuse, previous cholecystecotmy

Question 18

IBS drug for abdominal pain and constipation, that was temporarily withdrwan for cardiovascular events? Mechanism?

Answer 18

Tegaserod (zelnorm)

5-HT4 receptor agonist

Question 19

Drug used to treat women with IBS-C (temporarily withdrawn due to ischemic colitis)

Answer 19

Alosetron (Lotronex)

5-HT3 receptor antagonist

Question 20

Inhibitor of Na/H exchanges 3, that inhibits absorption from the intestines, treating constipation

Answer 20

Tenapanor (ibsrela)