NEEDS STATEMENT
Functional gastrointestinal (GI) disorders include an array of dysfunctions that occur in both the lower and the upper GI tract. These disorders—including irritable bowel syndrome, certain types of chronic constipation, nonulcer dyspepsia, and nonerosive esophageal reflux disease—have many overlapping symptoms that can often confound and confuse diagnosis. Furthermore, patients with functional GI motility disorders often have other comorbid conditions, such as fibromyalgia and psychiatric disorders, that can further complicate and delay accurate diagnosis. Recently, steps have been taken to better equip physicians with the necessary tools to properly diagnose functional GI disorders. New research has greatly enhanced our understanding of the pathophysiology of functional GI disorders, which is contributing to the development of novel and unique agents that address the multiple symptoms that often characterize these disorders.

TARGET AUDIENCE
This activity is intended for gastroenterologists and other professionals involved in the care of individuals with gastrointestinal motility disorders.

LEARNING OBJECTIVES
At the conclusion of this activity, participants should be able to:

1. Identify the appropriate use of criteria in diagnosing GI motility disorders.
2. Discuss the unique characteristics and physiologic features associated with scleroderma-related GI
   disorders.
3. Discuss the different tests used to diagnose and treat constipation-predominant irritable bowel syndrome (IBS-C) and medication-induced constipation.
4. Describe the treatment challenges commonly encountered with functional GI motility disorders.

ACCREDITATION STATEMENTS
Physician: This activity has been planned and implemented in accordance with the Essential Areas and Policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of CME Consultants, Inc. and McMahon Publishing Group. CME Consultants, Inc. is accredited by the ACCME to provide continuing medical education for physicians.

CME Consultants, Inc. designates this educational activity for a maximum of 1 Category 1 credit toward the AMA Physician's Recognition Award. Each physician should claim only those credits that he/she actually spent in the activity. Any questions regarding the accreditation of this CME activity should be directed to CME Consultants, Inc.

Physician Assistant: The American Academy of Physician Assistants (AAPA) accepts Category 1 credit from AMA Category 1 CME credit for the Physician's Recognition Award from organizations accredited by the ACCME.

Pharmacy: CME Consultants, Inc., has been accredited as a provider of Continuing Education
for Pharmacists by the Accreditation Council for Pharmacy Education (ACPE). In order to receive credit for this activity, all participants must complete an evaluation form and post-test certifying their completion of this activity. This activity has been accredited for 1 contact hour (0.1 CEU). There will be no fee for this activity. ACPE #309-999-05-012-H01. Initial Release Date: 10/1/2005. Planned Expiration Date: 10/31/2006.

Nursing: CME Consultants, Inc., is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation and designates this activity for 1.2 contact hours. In order to receive credit for this activity, all participants must complete an evaluation form and post-test certifying their completion of this activity. Participants should claim only those hours actually spent in the educational activity.

ESTIMATED TIME TO COMPLETION
This activity should take approximately 60 minutes to complete including the time to take the test and evaluation.

METHOD OF PARTICIPATION
This activity should take approximately 1 hour to complete. The participant should, in order, read the objectives and monograph, answer the 10-question, multiple-choice online post-test, and complete the online evaluation. The evaluation form provides each participant with the opportunity to comment on the quality of the instructional process, the perception of enhanced professional effectiveness, the perception of commercial bias, and his/her views on future educational needs. To receive credit for this activity, follow the post-test instructions. There is no fee associated with this activity. A score of 70% or better is required to receive credit. One retake is allowed. This credit will be valid through October 31, 2006. No credit will be given after this date.

FACULTY
Series Editor
Brian Lacy, PhD, MD
Associate Professor of Medicine
Department of Medicine
Division of Gastroenterology
Dartmouth—Hitchcock Medical Center
Lebanon, New Hampshire

Contributing Faculty
Brian Lacy, PhD, MD
Associate Professor of Medicine
Department of Medicine
Division of Gastroenterology
Dartmouth—Hitchcock Medical Center
Lebanon, New Hampshire

Brooks D. Cash, MD, FACP
Chief
Digestive Diseases Division and Colon Cancer Initiative
National Naval Medical Center
Bethesda, Maryland

Lin Chang, MD
Associate Professor
Department of Medicine
Division of Digestive Diseases
David Geffen School of Medicine
University of California, Los Angeles
Co-director
UCLA Center for Neurovisceral Sciences and Women's Health
Los Angeles, California

SYLLABUS DISCLOSURE STATEMENT
In direct response to the September 2004 ACCME Standards for Commercial Support, CME Consultants, Inc., issued a conflict of interest policy dated January 2, 2005. The policy states that the disclosure of potential financial conflicts of interest within the last 12 months must be made and resolved prior to date of the CME/CE activity where commercial support grants are to be used to fund the activity. The following conflicts have been managed and resolved through CME Consultants, Inc.'s Independent Review Committee. Our intent is to assist learners in assessing the potential for bias in information that is presented during the CME/CE activity.

The faculty is also aware it is their responsibility to inform the audience if discussion of any non-FDA approved uses of pharmaceutical, medical equipment, prostheses, etc, will be included in their presentation.

FACULTY DISCLOSURE STATEMENT
Brooks D. Cash, MD, FACP, has received honoraria from Novartis and Wyeth.
Lin Chang, MD, is a member of the advisory board and has received research support from Novartis.
Brian Lacy, PhD, MD, is a member of the advisory board and a consultant for Novartis.

FDA DISCLOSURE STATEMENT
The contents of some CME activities may contain discussions of off–label uses of some of the agents mentioned. Please consult the prescribing information for full disclosure of approved uses. This educational activity includes discussion of published and/or investigational uses tegaserod.

SOFTWARE REQUIREMENTS
Internet Explorer (v5.5 or greater) or Netscape (v7.02 or greater)
Adobe Acrobat Reader
Internet Explorer not supported on the Macintosh.
Windows 98 SE or above.

Jointly sponsored by CME Consultants, Inc., and McMahon Publishing Group.

         

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^©CME Consultants, Inc. 2005. All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or means without prior permission, except for the purposes of references and comment.

Although great care has been taken in compiling and checking the information contained in this Bulletin to ensure accuracy, neither the publisher nor CME Consultants, Inc. shall be liable for the accuracy of the information or for any errors, omissions, or inaccuracies in this publication.