Constipation: pathophysiology and management.
OBJECTIVE
Continuing advances in pharmaceutical development are providing an expanding array of treatment approaches for patients with chronic constipation. More comprehensive characterization of pancolonic motility carries the promise of improved understanding of the pathophysiology of this common disorder. Chronic constipation which responds poorly to laxatives may result from the use of drugs such as opioids, or from defecation disorders and advanced colonic dysmotility.


RESULTS
This article highlights improved characterization of pancolonic motility, evidence of efficacy of established and novel drugs for both idiopathic and opioid-induced constipation and a new algorithm for the evaluation of patients with chronic idiopathic constipation who respond inadequately to available laxatives.


CONCLUSIONS
The articles cited in this review inform the reader of new developments in the evaluation and treatment of patients with chronic constipation.
Division of Gastroenterology and Hepatology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA.
Arnold
A
Wald
D000701:Analgesics, Opioid / Q000009:adverse effects; D003248:Constipation / Q000139:chemically induced / Q000188:drug therapy* / Q000503:physiopathology*; D003672:Defecation / Q000502:physiology; D005772:Gastrointestinal Transit / Q000502:physiology; D006801:Humans; D054368:Laxatives / Q000627:therapeutic use*
D000701:Analgesics, Opioid; D054368:Laxatives