Expert Q&A

PUPC Recap—IBS-C and CIC Management in Primary Care: Diagnosis, Treatment, and Referral Strategies

Joel Heidelbaugh, MD

Key Highlights

  • Primary care clinicians can accurately diagnose irritable bowel syndrome with constipation (IBS-C) and chronic idiopathic constipation (CIC) and initiate appropriate therapy for most patients.
  • Evidence-based pharmacotherapy, including mechanisms of action and safety profiles, is central to effective management.
  • Recognition of alarm signs and symptoms is critical to identify potential organic disease and guide appropriate referral to gastroenterology.

As part of Consultant360’s coverage of the upcoming Practical Updates in Primary Care meeting (May 13–15), Joel J. Heidelbaugh, MD, Clinical Professor in the Departments of Family Medicine and Urology at the University of Michigan Medical School recaps key clinical insights from the session, “Advancing IBS-C and CIC in Primary Care Practice: Evidence-Based Approaches for Diagnosis, Treatment, and Person-Centered Management,” co-presented with William D. Chey, MD.

In this Q&A, Dr. Heidelbaugh discusses how primary care clinicians can accurately diagnose irritable bowel syndrome with constipation (IBS-C) and chronic idiopathic constipation (CIC), apply evidence-based pharmacologic treatments, recognize alarm symptoms, and determine when referral to gastroenterology is warranted.

Additional Resources: Practical Updates in Primary Care Agenda

Consultant360: What are some of the key themes of your presentation?
Joel J. Heidelbaugh, MD: We highlighted key strategies to enable primary care practitioners to safely and accurately diagnose IBS-C and CIC in the primary care setting. We also provided a detailed overview of pharmacotherapy, including mechanisms of action and safety profiles of available treatments.

Consultant360: Why is this topic particularly relevant right now?
Dr. Heidelbaugh: We are working to address gaps in knowledge in primary care, particularly related to the safe management of constipation. As new guidelines and evidence-based pharmacotherapeutic options become available, we hope this information will be readily applicable in clinical practice.

Consultant360: What are the most important takeaways from your session?
Dr. Heidelbaugh: Primary care practitioners can accurately and safely diagnose IBS-C and CIC and initiate appropriate therapy in the majority of patients. We also outlined alarm signs and symptoms suggestive of organic disease and provide a framework for appropriate referral to gastroenterology.

Consultant360: What gaps in our knowledge do you feel still remain on this topic?
Dr. Heidelbaugh: We did not have time to explore nutrition and dietary factors in depth, and these remain important gaps in knowledge.

Consultant360: Anything else you would like to add?
Dr. Heidelbaugh: Stay tuned—additional information will be forthcoming from the Rome Foundation regarding upcoming guidelines.

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