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Am Fam Physician. 2023;107(2):130

What is the preferred pharmacologic treatment for chronic constipation in adults?

First-line pharmacologic treatment options for normal transit and slow transit constipation include bulk laxatives and osmotic laxatives. Polyethylene glycol (Miralax) is the preferred osmotic laxative over lactulose for the treatment of constipation because it is more effective and has fewer adverse effects.

What initial treatment should be considered for patients with endometriosis symptoms?

The first-line treatment for symptoms of endometriosis is combined hormonal contraceptives. Patients presenting with clinical symptoms of endometriosis can start empiric treatment and then plan for diagnostic laparoscopy if symptoms do not improve or if medication is not tolerated.

When should patients be offered a spiritual assessment?

Consider offering a spiritual assessment to patients at hospitalization, if a significant clinical decline occurs in the hospital setting, when addressing end-of-life care, or when providing psychosocial services for the treatment of substance use disorders in the hospital setting.

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