title: Management of chronic constipation in general practice.
abstract: BACKGROUND
  Chronic constipation is often diagnosed and treated by general practitioners (GPs). The aim of the study was to evaluate the management of constipation by a cohort of Italian GPs.
  
  
  METHODS
  Over the course of 1 month, 41 GPs recorded tests and therapies suggested to patients complaining of chronic constipation. They were classified according to the Rome III criteria as constipated irritable bowel syndrome (C-IBS), functional constipation (FC), or "self-perceived constipation" (SPC) (not consistent with the Rome criteria).
  
  
  RESULTS
  The most frequently prescribed tests for the 229 patients (147 FC, 50 C-IBS, 32 SPC) were routine blood tests (59.3 %), abdominal ultrasounds (37.2 %), thyroid function (36.7 %), fecal occult blood tests (36.7 %), and tumor markers (35 %). Patient sex and age, GP age, and whether the diagnosis was new influenced the GP's request, but FC, C-IBS, or SPC status did not. Dietary suggestions (81.9 %), fiber supplements (59.7 %), reassurance (50.9 %), and laxatives (30.5 %) were the most frequently prescribed treatments. Antispasmodics were more frequently suggested for C-IBS patients; dietary suggestions, fiber, and enemas were more frequently prescribed in SPC patients. Patient and GP age and whether the diagnosis was new influenced the GP's choice of treatment.
  
  
  CONCLUSIONS
  The Rome III criteria do not influence diagnostic strategies and only slightly influence therapeutic strategies of GPs. Other factors (age, gender, new or old diagnosis) have more influence on GPs choice of investigations and treatment.
authors.affiliation: Gastrointestinal Unit, Department of Gastroenterology, University of Pisa, Via Paradisa No. 2, 56100, Pisa, Italy, mbellini@med.unipi.it.
authors.forename: M
authors.initials: M
authors.lastname: Bellini
authors.forename: D
authors.initials: D
authors.lastname: Gambaccini
authors.forename: S
authors.initials: S
authors.lastname: Salvadori
authors.forename: C
authors.initials: C
authors.lastname: Tosetti
authors.forename: M T
authors.initials: MT
authors.lastname: Urbano
authors.forename: F
authors.initials: F
authors.lastname: Costa
authors.forename: P
authors.initials: P
authors.lastname: Monicelli
authors.forename: M G
authors.initials: MG
authors.lastname: Mumolo
authors.forename: A
authors.initials: A
authors.lastname: Ricchiuti
authors.forename: N
authors.initials: N
authors.lastname: De Bortoli
authors.forename: S
authors.initials: S
authors.lastname: Marchi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D003248:Constipation / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy*; D005260:Female; D058006:General Practice; D006801:Humans; D043183:Irritable Bowel Syndrome / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy*; D007558:Italy; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome