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Your search term(s) "constipation" returned 61 results.

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Medication Induced Constipation And Diarrhea. Practical Gastroenterology. 32(5): 12-28. May 2008.

This article reviews the problems of constipation and diarrhea that occur as a side effect of medication use. The authors note that medication-induced constipation and diarrhea are frequent side effects that contribute to the costs of health care for evaluation and management and also contribute to patient morbidity. The diagnosis is often delayed due to poor association of symptom onset with the use of a medication. The authors define constipation; discuss its epidemiology, economic impact, and risk factors; consider diagnostic and treatment issues; and discuss the treatment of constipation in the setting of chronic opioid use. The next section covers the definition and mechanisms of medication-induced diarrhea, antibiotic-associated diarrhea, diarrhea associated with protease inhibitors, and chemotherapy-induced diarrhea. The authors conclude by encouraging health care providers to have a high index of suspicion when patients present with constipation or diarrhea and to obtain a detailed medication history of all medications taken in the past 2 months; this approach can avoid multiple diagnostic tests. High-risk patient populations for medication-induced diarrhea or constipation include the elderly, nursing home or long-term care residents, patients with chronic pain, those with prolonged hospitalization, and those being treated with broad spectrum antibiotics. 3 figures. 2 tables. 35 references.

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Constipation - Including Sigmoidocele and Rectocele. IN: Wexner, S.; Stollman, N., eds. Diseases of the Colon. . New York, NY: Informa Healthcare USA. 2007. pp 99-136.

This chapter about constipation is from a comprehensive text that offers chapters about each of the major colonic disorders. Most chapters are coauthored by at least one surgeon and one gastroenterologist to reflect the in-depth collaboration between these fields that is required for managing diseases of the colon. In this chapter, the author discusses constipation, including definition, prevalence and risk factors, history, physical examination, differential diagnosis, medical treatment, physiological investigation, pelvic flood dysfunction, biofeedback, rectocele, cul-de-sac hernias, enterocele and sigmoidocele, intussusception, perineal descent syndrome, combined colonic inertia with outlet obstruction, and normal evaluation. The author cautions that anorectal physiological testing does not reveal the cause in 25 to 50 percent of patients who complain of chronic constipation. Reasons for this include transient symptoms, misperceptions of the normal range of bowel patterns, or psychological causes of the symptoms. Treatment options include conservative therapy, laxatives, suppositories and enemas, prokinetic agents, and, in a small group of patients, surgery. The author concludes that a comprehensive physiologic investigation is crucial to successfully treat these challenging disorders. The chapter includes black-and-white photographs and illustrations and concludes with an extensive list of references. 8 figures. 3 tables. 249 references.

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Constipation, Diarrhea, Hemorrhoids and Fecal Incontinence. IN: Pregnancy in Gastrointestinal Disorders. 2nd ed. Bethesda, MD: American College of Gastroenterology. 2007. pp 4-9.

This chapter about constipation, diarrhea, hemorrhoids, and fecal incontinence is from a monograph that presents updated information about pregnancy in women with gastrointestinal disorders. The authors note that the pathophysiology of these common alterations in bowel patterns may be specific to hormonal and structural changes that occur during pregnancy and as a result of delivery. The chapter focuses on bringing readers up to date on the research in the area covered, the recommended treatments, and patient management concerns, notably issues of maternal and fetal safety. Specific topics include drug therapy, the use of dietary and behavioral modification to manage constipation, the etiology of diarrhea during pregnancy, oral rehydration for acute diarrhea, symptoms of hemorrhoids, the use of surgical hemorrhoidectomy, problems with diagnosing fecal incontinence, and treatment for fecal incontinence. The authors conclude that disturbances in bowel function are common in pregnancy and are often responsive to conservative medical therapy. 3 tables. 20 references.

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Constipation: Evaluation And Treatment of Colonic And Anorectal Motility Disorders. Gastroenterology Clinics of North America. 36(3): 687-712. September 2007.

This article on the evaluation and treatment of colonic and anorectal motility disorders characterized by constipation is from a special issue of Gastroenterology Clinics of North America that focuses on gastrointestinal (GI) motility. This article focuses on the colonic and anorectal motility disturbances that are associated with chronic constipation. Although many conditions such as metabolic problems, fiber deficiency, anorectal problems, and drugs can cause constipation, when these conditions are excluded, functional constipation can be diagnosed. The author categorizes functional chronic constipation into three overlapping subtypes: slow transit constipation, dyssynergic defecation, and irritable bowel syndrome (IBS) with constipation. The Rome III criteria may serve as a useful guide for making a clinical diagnosis of functional constipation. The author recommends an evidence-based approach to treat patients with chronic constipation. The availability of specific drugs for the treatment of chronic constipation, notably tegaserod and lubiprostone, has enhanced the therapeutic armamentarium for managing these patients. The author reports on the effectiveness of biofeedback therapy in the treatment of dyssynergic defecation. 4 figures. 3 tables. 118 references.

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Gastrointestinal Electrical Stimulation for Treatment of Gastrointestinal Disorders: Gastroparesis, Obesity, Fecal Incontinence, And Constipation. Gastroenterology Clinics of North America. 36(3): 713-734. September 2007.

This article on the use of electrical stimulation to treat gastroparesis, obesity, fecal incontinence, and constipation is from a special issue of Gastroenterology Clinics of North America that focuses on gastrointestinal (GI) motility. The authors note that because these organs have their own natural pacemakers the electrical signals they generate can be altered by externally delivering electric currents by intramuscular, serosal, or intraluminal electrodes to specific sites in the GI tract. They describe various methods of GI electrical stimulation and their peripheral and central effects and mechanisms; update the status of GI electrical stimulation in the clinical settings of gastroparesis, obesity, fecal incontinence, and constipation; and predict future directions and developments of GI electrical stimulation technology and their areas of possible clinical applications. The authors conclude that, although some of the research results are still equivocal, most studies indicate that electrical stimulation is able to alter certain GI functions. 9 figures. 1 table. 123 references.

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Managing Bowel Dysfunction. Bethesda, MD: National Institutes of Health Clinical Center. June 2007. 20 p.

This patient education fact sheet reviews the management of bowel dysfunction, defined as problems with the frequency, consistence, and/or ability to control the bowel movements. People may have trouble with their bowel movements due to many factors including medications, diseases or treatments for diseases, stress, or a change in eating or exercise patterns. The fact sheet reviews the physiology of the male and female digestive systems, normal bowel function, and the diagnosis of bowel problems with laboratory tests, radiologic or ultrasonic examination, special procedures, and fecal occult blood sampling. The fact sheet describes the causes, treatment, and prevention of bowel dysfunctions, including constipation, diarrhea, and fecal incontinence. A section considers specialized surgical procedures for bowel dysfunctions, including colostomy or ileostomy. Practical tips and strategies for everyday activities, meal planning, skin care, and exercise are provided; three sample menus are included. The fact sheet concludes with a brief glossary of relevant terms. 5 figures. 3 tables.

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Rifaximin as Acute Therapy and Maintenance Treatment for Functional Gastrointestinal Symptoms. Gastroenterology and Hepatology. 3(1): 9. January 2007.

This article is from a continuing education supplement that offers case studies that demonstrate the potential use of antibiotic therapy in the management of patients with functional gastrointestinal disorders. The cases provide examples of the pathogenic role of bacteria in irritable bowel syndrome (IBS) and suggest that treatment strategies that affect gut bacteria and the respective host responses to these pathogens might alleviate symptoms in patients with functional gastrointestinal symptoms. This article describes the case of a 55-year-old Caucasian woman who presented with a 10-year history of functional gastrointestinal symptoms, including mild diarrhea, severe constipation, abdominal pain, bloating, and gas. Symptoms were exacerbated by certain carbohydrates and alleviated only by not eating. A diagnosis of Rome II-positive, alternating-form irritable bowel syndrome (IBS) was determined. Based on clinical symptoms, the patient was administered oral rifaximin 400 milligrams twice daily for 10 days. Following completion of rifaximin treatment, probiotic therapy and tegaserod 2 milligrams daily were administered as maintenance therapy. At 3 months follow-up, the patient had not experienced symptom recurrence. The author briefly discusses the implications of this case study. 4 references.

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Understanding Constipation. Baltimore, MD: AGA Institute. 2007. 4 p.

This brochure from the American Gastroenterological Association (AGA) provides an overview of constipation, defined as the infrequent and difficult passage of stool. The brochure reviews common misconceptions about constipation and bowel habits and outlines the causes of constipation, which can include poor diet, imaginary constipation, irritable bowel syndrome (IBS), poor bowel habits, laxative abuse, travel, hormonal disturbances, pregnancy, fissures and hemorrhoids, specific diseases, loss of body salts, mechanical compression, nerve damage, medications, and colonic motility disorders. The brochure describes constipation in children, constipation in older adults, when to seek medical attention for constipation, diagnostic tests that may be used to confirm the condition, and treatment options. One section reviews the different types of laxatives, including bulk-forming, stimulants, osmotics, stool softeners, lubricants, saline laxatives, and chloride channel activators. A final section summarizes the basic information presented in the brochure. One illustration presents the organs of the digestive system labeled in a simple line drawing. Readers are referred to the AGA website at for more information about digestive health and to find a local AGA member physician. 2 figures.

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Understanding Irritable Bowel Syndrome. Baltimore, MD: AGA Institute. 2007. 4 p.

This brochure from the American Gastroenterological Association (AGA) provides an overview of irritable bowel syndrome (IBS), a common disorder of the intestine that leads to crampy pain, gassiness, bloating, and changes in bowel habits, including constipation and diarrhea. The brochure reviews the lifestyle impact of IBS and outlines the causes and triggers of the condition, which can include problems with colonic motility, an oversensitive gastrointestinal tract, certain foods, hormones associated with the menstrual cycle, and emotional conflict or stress. The brochure describes how IBS is diagnosed, the relationship between IBS and more serious problems, and treatment options, including the role of a healthy diet, dietary fiber, small meals, and the role of medicines in relieving IBS symptoms. Another section explores the interplay between diet, stress, and IBS. A final section summarizes the basic information presented in the brochure. One illustration presents the organs of the digestive system labeled in a simple line drawing. Readers are referred to the AGA website at for more information about digestive health and to find a local AGA member physician. 6 figures.

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Evaluation and Treatment of Constipation in Infants and Children. American Family Physician. 73(3): 479-480. February 1, 2006.

This article reviews the evaluation and treatment of constipation in infants and children, a problem that is usually functional and the result of stool retention. However, the authors encourage family physicians to be alert for indications of the presence of an uncommon but serious organic cause of constipation, such as Hirschsprung's disease, also called congenital aganglionic megacolon; pseudo-obstruction; spinal cord abnormality; hypothyroidism; diabetes insipidus; cystic fibrosis; gluten enteropathy; or congenital anorectal malformation. Functional constipation is treated with disimpaction using oral or rectal medication. Polyethylene glycol is effective and well-tolerated, but a number of alternatives are also available. After disimpaction, children may need to be on a maintenance program for months to years because relapse of functional constipation is common. Education of the family and, when possible, the child is important for improving functional constipation. Cow's milk may promote constipation in some children, so a trial period of withholding milk may be considered. Adding fiber to the diet is another recommended strategy. The authors conclude that, despite treatment, only 50 to 70 percent of children with functional constipation demonstrate long-term improvement. Two patient care algorithms are provided. 2 figures. 6 tables. 18 references.

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