Chronic Constipation.

Abstract:

:Constipation is a common symptom that may be primary (idiopathic or functional) or associated with a number of disorders or medications. Although most constipation is self-managed by patients, 22% seek health care, mostly to primary care physicians (>50%) and gastroenterologists (14%), resulting in large expenditures for diagnostic testing and treatments. There is strong evidence that stimulant and osmotic laxatives, intestinal secretagogues, and peripherally restricted μ-opiate antagonists are effective and safe; the lattermost drugs are a major advance for managing opioid-induced constipation. Constipation that is refractory to available laxatives should be evaluated for defecatory disorders and slow-transit constipation using studies of anorectal function and colonic transit. Defecatory disorders are often responsive to biofeedback therapies, whereas slow-transit constipation may require surgical intervention in selected patients. Both efficacy and cost should guide the choice of treatment for functional constipation and opiate-induced constipation. Currently, no studies have compared inexpensive laxatives with newer drugs that work by other mechanisms.

journal_name

Mayo Clin Proc

journal_title

Mayo Clinic proceedings

authors

Bharucha AE,Wald A

doi

10.1016/j.mayocp.2019.01.031

subject

Has Abstract

pub_date

2019-11-01 00:00:00

pages

2340-2357

issue

11

eissn

0025-6196

issn

1942-5546

pii

S0025-6196(19)30123-5

journal_volume

94

pub_type

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