Chronic Constipation
Peter Sagar, Andrew G. Hill, Charles H. Knowles, Stefan Post, Willem A. Bemelman, Patricia L. Roberts, Susan Galandiuk, John R.T. Monson, Michael R.B. Keighley, Norman S. Williams in Keighley & Williams’ Surgery of the Anus, Rectum and Colon, 2019
Constipation is not a disease. Rather, it is a symptom reported by patients who believe that there is a disturbance of the events they perceive to comprise normal defaecation. As such, patients may associate a wide variety of symptoms with the term constipation, including those apparently more related to defaecation e.g. infrequency of bowel action, loss of urge to defaecate, straining, incomplete, painful or unsuccessful evacuation, or more diverse symptoms such as abdominal and back pain, bloating or nausea. Without agreement over what constitutes normality or abnormality in terms of the type or frequency of symptoms reported by patients, clearly the definition of constipation is highly subjective. In practice, patients present when their personal situation is unsatisfactory.
Management of Conditions and Symptoms
Amy J. Litterini, Christopher M. Wilson in Physical Activity and Rehabilitation in Life-threatening Illness, 2021
Unresolved or untreated chronic constipation can lead to fecal impaction and bowel obstruction. For the appropriate patient, and with communication with the medical provider, light abdominal massage may be a beneficial modality to consider for individuals with chronic constipation. Instruction in abdominal massage, particularly for individuals with Parkinson’s disease, has shown to be beneficial.84 Rectal suppositories and oil retention enemas may be successful in mild cases, and in severe cases, manual digital disimpaction (under the order of a physician and within the scope of nursing practice) can potentially address fecal impaction while the source is being evaluated to prevent recurrence. In patients with a suspected bowel obstruction, urgent medical intervention should be recommended and/or provided. For patients still wishing for intensive medical intervention in the presence of a life-threatening illness, strategies such as corticosteroids to relieve the obstruction can often be effective prior to the consideration for surgical intervention.85
Gastroenterology and hepatology
Fazal-I-Akbar Danish in Essential Lists of Differential Diagnoses for MRCP with diagnostic hints, 2017
Chronic constipation:1 Diet and life style (low fibre/low fluid intake; sedentary).2 Persistent and intentional suppression of the urge to defaecate/poor bowel training.3 Hypothyroidism.4 Irritable bowel syndrome.5 Drugs (opioids; anticholinergics; tricyclics; aluminium-containing antacids; diuretics).6 Hypercalcaemia.7 Autonomic neuropathy (d/t DM; acute intermittent porphyria; lead poisoning).8 Megacolon (Hirschsprung’s disease; complication of ulcerative colitis).
Use of prucalopride in adults with chronic idiopathic constipation
Published in Expert Review of Clinical Pharmacology, 2019
Priya Vijayvargiya, Michael Camilleri
Chronic constipation is defined as decreased frequency of bowel movements (1 bowel movement every 3 days) or harder stool consistency (≤ type 3 Bristol stool form scale) at least 25% of the time for over 3 months [1]. In a systematic review and meta-analysis, the pooled prevalence of chronic idiopathic constipation was 14% (95% CI 12–17%) of the population, with higher rates in women [OR 2.22 (95% CI 1.87–2.62)], increased age, and lower socioeconomic status [2]. In community-based epidemiological studies in the United States, the overall age-adjusted and sex-adjusted prevalence (per 100 individuals) of normal transit constipation was 19.2 (95% CI 16.1–22.3) [3]. There was no significant increase in the prevalence of chronic idiopathic constipation in patients >50 years of age compared to those ≤50 years of age [2,4].
Quercetin promotes gastrointestinal motility and mucin secretion in loperamide-induced constipation of SD rats through regulation of the mAChRs downstream signal
Published in Pharmaceutical Biology, 2018
Ji Eun Kim, Mi Rim Lee, Jin Ju Park, Jun Young Choi, Bo Ram Song, Hong Joo Son, Young Whan Choi, Kyung Mi Kim, Jin Tae Hong, Dae Youn Hwang
Constipation is well known as an acute or chronic gastrointestinal disease characterized by infrequent bowel movements, hard and dry faeces, incomplete bowel evacuation and difficulty during defecation (Walia et al. 2009). Until now, several drugs were developed to treat this disease. In most cases, chemical drugs (laxatives) including Senna™, Correctol®, Exlax®, Senokot™ and Gaviscon® act as stimulants to increase bulkiness and soften stool or as osmotic agents, trigger bowel movements and enhance water flow into the colon to promote elimination (Voderholzer et al. 1997). But, most of above drugs showed some undesirable side effects, such as myocardial infarction, artery contraction and coronary spasms (Lembo and Camilleri 2003; Busti et al. 2004; Kim et al. 2013). Therefore, many studies have focused on identifying novel laxatives with no side effects to treat constipation patients. As part of above studies, we investigated the laxative effect and action mechanism of QCT in Lop-induced constipation model. The results of the present study first demonstrated that QCT can improve the symptoms of constipation through the elevation of stool excretion, and the recovery of histological changes of the transverse colon in Lop-induced constipation model. Especially, our data show the laxative effects of QCT are tightly correlated with the interaction between QCT and mAChR M2/3 signalling pathway.
Absorption, disposition, metabolism and excretion of [14C]mizagliflozin, a novel selective SGLT1 inhibitor, in rats
Published in Xenobiotica, 2019
Hitoshi Ohno, Yasunari Kojima, Hiroshi Harada, Yoshikazu Abe, Takuro Endo, Mamoru Kobayashi
Chronic constipation is a highly common gastrointestinal (GI) disorder. The main symptoms of chronic constipation include infrequent bowel movements, hard stools, straining during defaecation, a feeling of incomplete evacuation, abdominal discomfort and a sensation of bloating (McCallum et al., 2009). Chronic constipation adversely affects the quality of life of patients and increases their economic burden (Sun et al., 2011). Limited therapeutic options are available for treating chronic constipation at present. Commonly used treatment options include saline, stimulant, osmotic and bulk laxatives (Fukudo et al., 2011; Longstreth et al., 2006). However, approximately 50% of patients with chronic constipation are not satisfied with their current treatment, mostly because of a lack of efficacy (Johanson & Kralstein, 2007). This highlights a continued medical need for more effective and safer therapeutic agents.
Related Knowledge Centers
- Anal Fissure
- Defecation
- Diabetes
- Fecal Impaction
- Gastrointestinal Tract
- Irritable Bowel Syndrome
- Pelvic Floor
- Hemorrhoid
- Feces
- Hypothyroidism