title: Approach to patients with refractory constipation.
abstract: Constipation is a very frequent problem, particularly in elderly patients. Constipation is a common reason for patients to seek medical advice, and it accounts for a large number of different prescription and over-the-counter medications. In many cases, no definite cause can be found. Most patients respond to conservative therapy with increased fiber and fluid intake alone. Patients with constipation that is more difficult to control or with alarm symptoms (eg, blood in stool, sudden onset, weight loss, or decreasing stool caliber) warrant further investigation. A variety of medical, behavioral, and surgical therapies can be employed to help these more refractory patients.
authors.affiliation: Division of Gastroenterology, Hepatology, and Nutrition, University of Florida, Department of Medicine, Veterans Administration Medical Center, Research Service (151), 1601 SW Archer Road, Gainesville, FL 32608, USA.
authors.forename: S A
authors.initials: SA
authors.lastname: Wofford
authors.forename: G N
authors.initials: GN
authors.lastname: Verne
mesh_terms: D001676:Biofeedback, Psychology; D002400:Cathartics / Q000627:therapeutic use; D003248:Constipation / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000628:therapy; D004043:Dietary Fiber / Q000627:therapeutic use; D005769:Gastrointestinal Motility; D006801:Humans; D009294:Narcotics / Q000009:adverse effects
chemical_list: D002400:Cathartics; D004043:Dietary Fiber; D009294:Narcotics