QIIESIIIOII 65 S. B. is a 41—year—old female who presents complaining of constipation. She says she has never
had problems with bowel movements in the past, although she has heard that constipation is
common among women. She says that for the last month or so she has been lucky to have three
bowel movements a week, and even when she has one, she doesn’t always feel empty. A review
of systems is otherwise negative, and she denies taking any new medications. She denies
depression or any mood disorders—she says she actually is very happy and has always felt well,
but this bowel problem is bothering her. She has tried over-the-counter products such as
Metamucfl® and stool softeners, but nothing has helped. Her abdominal, pelvic, and rectal
examinations are normal—there are good bowel sounds, no organomegaly, and no discomfort on
palpation. The AGACNP considers ordering: