Practice Management
Kids who have irritable bowel syndrome with constipation (IBS-C) now have a new treatment option as the Food and Drug Administration (FDA) this month approved linaclotide for pediatric patients 7 years and older. There is no known underlying cause for IBS-C in children, and symptoms include chronic constipation and abdominal pain. Linaclotide is the first treatment approved for IBS-C in pediatric patients with a recommended dose of 145 mcg orally once daily. A 12-week, double-blind, …
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The guanylate cyclase C agonist, linaclotide (Linzess), doubled weekly bowel movements among children age 6 and younger, helping to treat pediatric patients with functional constipation, according to a study published in Lancet Gastroenterology & Hepatology. As a recently approved treatment option, linaclotide demonstrated improvement in frequency over placebo with 57% of patients in the treatment group experiencing a spontaneous bowel movement within the first 48 hours of receiving the drug. Authors also observed improvement in …
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Urgent message: Prescribing Miralax and an enema would likely have killed this patient. He nearly died in the hospital. Can you figure out why? WILLIAM A. GLUCKMAN, DO, MBA, FACEP, CPE, CPC Constipation, a common urgent care complaint, can be a symptom of many things, not all of them obvious, and some life-threatening. In this tricky case, the underlying problem is one that many urgent care physicians would not consider in a differential diagnosis, yet …
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Urgent message: Malignancies in children are often discovered only inadvertently, in conjunction with seemingly less dire presentations. Awareness of relevant signs and symptoms by the urgent care clinician can be invaluable in identifying tumors that might otherwise escape notice until they are at an advanced stage. Muhammad Waseem, MD Introduction The identification of a palpable abdominal mass in an urgent care center or emergency department is quite concerning, as it represents a serious underlying disorder. …
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Urgent message: Constipation can be a sign of serious – even life-threatening – etiologies. Once non-benign causes have been ruled out, emphasis should be on evacuation and dietary and lifestyle changes to prevent recurrence. Claire West, MD, Samuel M. Keim, MD, MS, and Peter Rosen, MD Introduction Constipation is a common complaint, accounting for approximately 2.5 million doctor visits annually. With increasing difficulty in obtaining a quick appointment with a primary care physician, more and …
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The patient is a young child with three days of constipation with a non-specific history of abdominal pain. On exam, the child is asleep. The abdomen is easily palpable and soft. Physical exam reveals no other remarkable factors. View the x-ray taken and consider what your diagnosis and next steps would be.
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