Beyond the Old Paradigms: Novel Approaches to the Treatment of Chronic Idiopathic Constipation


Anthony J. Lembo, MD
Director, GI Motility Laboratory, Division of Gastroenterology
Beth Israel Deaconess Medical Center, Boston, MA
Anthony J. Lembo, MD

Anthony J. Lembo, MD, is a Professor of Medicine at Harvard Medical School. He also serves as the Director of the GI Motility Laboratory at the Beth Israel Deaconess Medical Center (BIDMC) Division of Gastroenterology in Boston, MA. Dr. Lembo earned his undergraduate degree in mathematics at Amherst College in Amherst, MA and then received his MD from Tufts Medical School in Boston, MA. He subsequently completed his internal medicine internship/residency as well as gastroenterology fellowship at UCLA Medical Center in Los Angeles, CA. Dr. Lembo subsequently became a Clinical Instructor of Medicine at UCLA in 1996 and served as the co-Director of the Functional Bowel Disorder (FBD) and Gastrointestinal (GI) Motility Center at UCLA Medical Center. While at UCLA he conducted research in FBDs. In 1997 he joined the faculty at BIDMC in Boston MA. Dr. Lembo is currently the Director of the GI Motility and Functional Bowel Disorder Center at the BIDMC and Co-Director of the GI Motility Laboratory. He is an Associate Editor of Journal of Clinical Gastroenterology and Digestive Diseases and Science. His research has focused on the developed of novel treatments for FBDs including chronic idiopathic constipation. Dr. Lembo’s research interest has also explored the role of placebo and methods of enhancing the placebo response.

William D. Chey, MD, AGAF, FACG, FACP
Timothy T. Nostrant Collegiate Professor of Gastroenterology
Chief, Division of Gastroenterology & Hepatology and Professor of Nutrition Sciences
Departments of Internal Medicine and Nutritional Sciences, Michigan Medicine, University of Michigan, Ann Arbor, MI
William D. Chey, MD, AGAF, FACG, FACP

Dr. Chey received a medical degree and training in internal medicine at Emory University School of Medicine. He completed a fellowship in gastroenterology and has remained as faculty at the University of Michigan in Ann Arbor where he is currently the Timothy T. Nostrant Collegiate Professor of Gastroenterology. He holds a joint appointment in the Department of Nutrition Sciences.

Dr. Chey’s research interests focus on the diagnosis and treatment of functional bowel disorders and H. pylori infection. He has mentored more than 50 students, residents, fellows, and junior faculty, many of which are leaders in gastroenterology. He is a medical innovator and holds several patents. Dr. Chey is former Co-Editor-in-Chief of the American Journal of Gastroenterology and has authored more than 350 manuscripts, reviews, chapters, and books. He is a member of the Board of Trustees of the American College of Gastroenterology, Board of Directors of the Rome Foundation, Council of the American Neurogastroenterology and Motility Society, and Board of Directors of the International Foundation of Functional Gastrointestinal Disorders.

Dr. Chey has been elected to “Best Doctors” since 2001 and received the Dean’s Outstanding Clinician Award and Dean’s Award for Innovation and Commercialization at the University of Michigan. He has also received the Distinguished Clinician Award from the American Gastroenterological Association. In 2020 he was awarded honorary membership to the Academy of Nutrition and Dietetics and the prestigious Berk/Fise Award from the American College of Gastroenterology.

Douglas A. Drossman, MD
President, Drossman Center for the Education and Practice of Biopsychosocial Care LLC
President, Drossman Consulting LLC
President Emeritus and COO, Rome Foundation
Professor Emeritus of Medicine and Psychiatry University of North Carolina School of Medicine
Former Co-Director, UNC Center for Functional GI and Motility Disorders
Douglas A. Drossman, MD
President, Drossman Center for the Education and Practice of Biopsychosocial Care LLC

Dr. Drossman received his MD degree at Albert Einstein College of Medicine and subspecialized in biopsychosocial (psychosomatic) medicine and gastroenterology. He is a Fellow of the American College of Physicians, a Master of the American College of Gastroenterology, Past-President of the American Psychosomatic Society (1997), and Founder and President of the Rome Foundation (for 29 years).

Dr. Drossman has founded multiple organizations to advance patient-centered education and treatment of disorders of gut-brain interaction (DGBIs). He founded the Rome Foundation, a non-profit whose mission is to improve the lives of individuals with DGBIs. He served as its President from its inception until May 2019 (, and is currently its President Emeritus and Chief of Operations. Dr. Drossman has served as Senior Editor of the textbooks Functional Gastrointestinal Disorders Rome I, II, III, and IV as well as other Rome IV products released since 2016: Multi-Dimensional Clinical Profile for Functional Gastrointestinal Disorders (completing 2nd edition), Rome IV Clinical Algorithms (2nd edition), Rome IV Slide Sets, and Rome IV GI Genius (an intelligent software application). In his gastroenterology practice, he receives referrals nationally to consult or manage the care of difficult-to-diagnose and -treat patients with functional gastrointestinal and motility disorders.

As Founder and President of DrossmanCare (Center for Education and Practice of Biopsychosocial Care) Dr. Drossman produces educational materials to teach patient-centered care for patients with DGBIs. He has produced peer-reviewed articles and videotapes on medical interviewing and the patient-doctor relationship. Dr. Drossman also facilitates workshops and communication skills training programs and has received numerous awards, both as an educator and practitioner. Most recently, he has been collaborating with the Rome Foundation to produce a curriculum for training clinicians that includes the Communication 101 and 202 video series, Train the Trainer programs, and workshops and symposia globally.

Dr. Drossman has written over 500 articles and book chapters, serves on six editorial and advisory boards, was Associate Editor of the journal Gastroenterology, and was the Gastroenterology Section Editor of the Merck Manual (for 17 years).

His research relates to the clinical, epidemiological, psychosocial, and treatment aspects of gastrointestinal disorders, and he has been principal investigator in several federally funded epidemiological, outcomes, and abuse grants, including brain imaging in irritable bowel syndrome.

Statement of Need

Chronic idiopathic constipation (CIC) affects 35 million adults in the United States, making it one of the most common gastrointestinal disorders. Despite the high prevalence, CIC is often underdiagnosed and undertreated, which exacts a functional, psychosocial, and economic toll on patients and their loved ones. The current treatment goal in CIC is multi-symptom relief, but only 16% of patients with CIC are on prescription therapy, and they often only obtain partial relief, with many using laxatives on a regular basis without medical supervision.

This CME Outfitters OnDemand features evidence-based dialogue that focuses on guideline recommendations for diagnosing patients with CIC, assessing the efficacy and safety of novel pharmacotherapeutic options, and implementing strategies for multidisciplinary collaboration, with the goal of providing full relief to patients with CIC.

Learning Objectives

At the end of this CME/CE activity, participants should be able to:

  • Follow guideline recommendations to diagnose patients with CIC and set appropriate treatment goals.
  • Assess efficacy and safety of novel pharmacotherapeutic options in order to provide full relief to patients with CIC.
  • Implement strategies for multidisciplinary collaboration and care coordination in order to achieve treatment goals and improve patient outcomes.

The following learning objectives pertain only to those requesting CNE or CPE credit:

  • Identify guideline recommendations for diagnosing patients with CIC.
  • Assess efficacy and safety of novel pharmacotherapeutic options for providing full relief to patients with CIC.
  • Describe strategies for multidisciplinary collaboration and care coordination for achieving treatment goals and improved patient outcomes.

Financial Support

Supported by an educational grant from Takeda Pharmaceuticals U.S.A., Inc.

Target Audience

Gastroenterologists, PAs, nurse practitioners, nurses, and pharmacists.

Credit Information

Physicians (ACCME) 1.0

CME Outfitters, LLC, designates this enduring material for a maximum of 1.0 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Note to Nurse Practitioners

Nurse Practitioners can apply for AMA PRA Category 1 Credit through the American Academy of Nurse Practitioners (AANP). AANP will accept AMA PRA Category 1 Credit  from organizations accredited by the Accreditation Council for Continuing Medical Education. Nurse practitioners can also apply for credit through their state boards.

Pharmacists/Pharmacy Tech (ACPE) 1.0

This application-based activity is approved for 1.0 contact hour (0.10 CEUs) of continuing pharmacy credit.


Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 1.0 medical knowledge MOC point in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.

MIPS Improvement Activity

Completion of this accredited CME activity meets the expectations of an Accredited Safety or Quality Improvement Program (IA_PSPA_28) for the Merit-based Incentive Payment Program (MIPS). Clinicians should submit their improvement activities by attestation via the CMS Quality Payment Program website.

Disclosure Declaration

It is the policy of CME Outfitters, LLC, to ensure independence, balance, objectivity, and scientific rigor and integrity in all of their CE activities. Faculty must disclose to the participants any relationships with commercial companies whose products or devices may be mentioned in faculty presentations, or with the commercial supporter of this CE activity. CME Outfitters, LLC, has evaluated, identified, and attempted to resolve any potential conflicts of interest through a rigorous content validation procedure, use of evidence-based data/research, and a multidisciplinary peer review process. The following information is for participant information only. It is not assumed that these relationships will have a negative impact on the presentations.

Dr. Lembo reports that he receives research support from: Ironwood Pharmaceuticals, Inc.; Takeda Pharmaceuticals U.S.A., Inc.; and Vanda Pharmaceuticals Inc. He is on the advisory committee for Cara Care. He is a consultant for Ardelyx; Ironwood Pharmaceuticals, Inc; Mylan; Salix Pharmaceuticals; Shire; Takeda Pharmaceuticals U.S.A., Inc.; and Vibrant Pharma Inc.

Dr. Chey reports that he receives grants and research support from Biomerica, Inc.; Commonwealth Diagnostics International, Inc.; QOL Medical; Urovant Sciences, Inc.; Vibrant Pharma Inc.; and Zespri. He is a consultant for AbbVie Inc./Allergan; Alnylam Pharmaceuticals Inc.; Arena Pharmaceuticals, Inc.; Biomerica, Inc.; Gemelli Biotech; IM Health; Ironwood Pharmaceuticals, Inc.; Phathom Pharmaceuticals; Progenity, Inc.; QOL Medical; RedHill Biopharma Inc.; Ritter Pharmaceuticals Inc.; Salix Pharmaceuticals/Valeant Pharmaceuticals; Urovant Sciences, Inc.; and Vibrant Pharma Inc. He is a stock shareholder (directly purchased) for Options: GI OnDEMAND; ModifyHealth, LLC; and Ritter Pharmaceuticals Inc.

Dr. Drossman has no disclosures to report.

Jeffrey Helfand, DO (peer reviewer) has no disclosures to report.

Mae Ochoa, RPh (peer reviewer) has no disclosures to report.

Olga Askinazi, PhD (planning committee) has no disclosures to report.

Susan Perry (planning committee) has no disclosures to report.

Jan Perez (planning committee) has no disclosures to report.

Sharon Tordoff (planning committee) has no disclosures to report.

Disclosures were obtained from the CME Outfitters, LLC staff: No disclosures to report.

Faculty of this CE activity may include discussions of products or devices that are not currently labeled for use by the FDA. The faculty have been informed of their responsibility to disclose to the audience if they will be discussing off-label or investigational uses (any uses not approved by the FDA) of products or devices.

Obtaining Credits

Post-tests, credit request forms, and activity evaluations must be completed online (requires free account activation), and participants can print their certificate or statement of credit immediately (75% pass rate required). This website supports all browsers except Internet Explorer for Mac. For complete technical requirements and privacy policy, visit our Privacy & Confidentiality page.


NOTE: Pharmacist CE Universal Activity Number, Enduring: 0376-0000-20-111-H01-P.


Questions about this activity?

Call us at 877.CME.PROS (877.263.7767).



Beyond the Old Paradigms: Novel Approaches to the Treatment of Chronic Idiopathic Constipation
Event Date: 08/19/2020