title: How to deal with chronic constipation. A stepwise method of establishing and treating the source of the problem.
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.
authors.affiliation: Gastroenterology Service, Brooke Army Medical Center, San Antonio, Texas 78234, USA. BRBPR@aol.com
authors.forename: P W
authors.initials: PW
authors.lastname: Wong
authors.forename: S
authors.initials: S
authors.lastname: Kadakia
mesh_terms: D001004:Anus Diseases / Q000150:complications / Q000628:therapy; D001676:Biofeedback, Psychology; D002400:Cathartics / Q000627:therapeutic use; D002908:Chronic Disease; D003109:Colonic Diseases, Functional / Q000150:complications / Q000188:drug therapy / Q000628:therapy; D003113:Colonoscopy; D003248:Constipation / Q000145:classification / Q000209:etiology / Q000628:therapy*; D003672:Defecation; D004043:Dietary Fiber / Q000627:therapeutic use; D004326:Drinking; D005769:Gastrointestinal Motility; D005772:Gastrointestinal Transit; D006801:Humans; D010353:Patient Education as Topic; D026741:Physical Therapy Modalities; D012002:Rectal Diseases / Q000150:complications / Q000628:therapy
chemical_list: D002400:Cathartics; D004043:Dietary Fiber