The approach to diagnosis and treatment of chronic constipation: suggestions for a general practitioner.
Can J Gastroenterol
; 25 Suppl B: 36B-40B, 2011 Oct.
Article
en En
| MEDLINE
| ID: mdl-22114756
ABSTRACT
Chronic constipation is a frequent complaint. Symptoms of obstructive defecation (straining, hard and lumpy stools, or incomplete evacuation) are more frequent and bothersome than the frequency of bowel movements. Patient assessment is clinically based on the presence or absence of red flags. Commonly used therapies (eg, bulk-forming agents, stool softeners and stimulant laxatives) have only been evaluated in small studies of short duration. Polyethylene glycol was shown to be effective and safe in several rigorous trials with durations of more than one year. New drugs (prucalopride, lubiprostone and linaclotide) were shown to be effective and safe in well-designed and rigorous studies. Trials conducted in primary care patients are lacking for all therapies. Biofeedback and behavioural therapies are effective, but should be reserved for selected patients after proper diagnostic evaluation. A practical management algorithm is proposed using a multistep approach favouring early introduction of combined therapies and long-term step-down strategy to the lowest satisfactory regimen.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Estreñimiento
Tipo de estudio:
Diagnostic_studies
Límite:
Humans
Idioma:
En
Revista:
Can J Gastroenterol
Asunto de la revista:
GASTROENTEROLOGIA
Año:
2011
Tipo del documento:
Article