How to deal with chronic constipation

Abstract

Chronic constipation is a common medical complaint encountered often in a primary care setting. Most patients can be treated successfully with simple measures, including education, bowel habit training, increased fluid and fiber intake, and use of laxatives. Chronic constipation is usually considered idiopathic, but secondary causes should be excluded. In about 1% of patients with severe, intractable constipation, further diagnostic testing (e.g., endoscopy, colonic transit study) is needed. Patients with colonic inertia can be treated with judicious use of laxatives, but surgery may be necessary in a few cases. Patients with outlet inertia should be referred for biofeedback treatment.

Older people seeking solutions to constipation: the laxative mire

“…Older people commonly report that they are constipated (Abyad & Mourad, 1996; Wilson, 1999; Wong & Kadakia, 1999). Surveys internationally suggest that between 20% and 50% of older people living in the community have symptoms of constipation (Harari et al ., 1996; Petticrew et al ., 1997; Chiarelli et al ., 2000), yet there is little research that addresses the nature of this phenomenon, the impact of constipation on them, and how they try to avoid it.…”

Effectiveness of bran supplement in older orthopaedic patients with constipation

“…1997). Wong and Kadakia (1999) and Locke et al. (2000) classify constipation according to normal or slow transit through the intestines with slow transit divided into colonic inertia or outlet inertia.…”

“…It is especially prevalent among older people. (Taylor 1990, Abyad & Mourad 1996, Wilson 1999, Wong & Kadakia 1999. Surveys internationally suggest that between 20% and 50% of older people living in the community have symptoms of constipation (Harari et al 1996, Petticrew et al 1997, Chiarelli et al 2000.…”

“…The term constipation is used primarily to refer to difficulty in defecation and/or infrequency, which is not secondary to some underlying cause (Petticrew et al 1997). Wong and Kadakia (1999) and Locke et al (2000) classify constipation according to normal or slow transit through the intestines with slow transit divided into colonic inertia or outlet inertia. Important factors contributing to its occurrence are inadequate fluid intake, lack of exercise, immobilization, insufficient intake of dietary fibre and adverse medication reactions (Burkit 1982, Resnick 1985, Potter & Perry 1995.…”