Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “CONSTIPATION”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,243 records · Page 69Linked to original sources
PubMed2001

Tegaserod for the treatment of constipation-predominant irritable bowel syndrome.

Tegaserod, a potent, partial serotonin 4 receptor (5-HT4) agonist, is an effective agent for the treatment of females with constipation-predominant irritable bowel syndrome. Tegaserod enhances gastric motility, stimulates peristaltic reflux and intestinal secretion, inhibits visceral sensitivity, and/or shortens colonic transit time. This agent may help women who have failed to respond to diet and exercise, laxatives, and other forms of therapy. The optimal dose of tegaserod is 6 mg twice daily and results in decreased number of days per month with pain, bloating, and days without bowel movements. Tegaserod is less effective in males than females in the treatment of constipation-predominant irritable bowel syndrome. Tegaserod is well tolerated. Diarrhea is the most frequent adverse effect. The diarrhea tends to occur most frequently during the first few months of therapy and decreases with continued administration.

Clinical Trials, Phase III as Topic↗
PubMed2002

Constipation overview: evaluation and management.

Constipation is variably defined, but usually refers to persistent, difficult, infrequent, or seemingly incomplete defecation. An exhaustive list of possible factors may contribute to chronic constipation. Most patients are successfully treated without elaborate, expensive diagnostic procedures, by implementing simple alterations in diet and lifestyle. In the small percentage of patients in whom this fails, a more in-depth analysis of the problem may lead to more specialized forms of therapy. Bowel retraining, or biofeedback, often serves as a foundation for further therapy, but pharmacologic aids or surgery may also be necessary. Unfortunately, results in these patients are not universally optimistic, but patient selection is the key.

Constipation↗
PubMed1976

Constipation and catharsis.

Constipation is endemic in the Western world. Stool consistence and associated symptoms are more important than stool frequency. The patient's attitude towards his bowel habit is also important. Exclusion of "organic" disease, reassurance and discussion of normal variations of bowel habit are necessary first steps in treatment. Adquate bulk in the stool must be ensured, either through diet or bulking agnets, and bowel retraining attempted. Laxatives should be reserved for episodes of constipation following enforced bedrest, or as a preparation for diagnostic procedures. Long-term use should be avoided.

Cathartics↗
PubMed2003

[Functional childhood gastrointestinal disorders. III. Constipation and solitary encopresis; diagnostic work-up and therapy].

A detailed medical history in combination with a thorough physical examination, including rectal examination, form the cornerstone in the diagnostic work-up for children with functional defecation disorders. Additional investigations are often not informative and have only minor diagnostic or therapeutic implications. Medical therapy in children with functional constipation and solitary encopresis is primarily based on clinical experience. In both patient groups, the role of education, the use of diary cards and toilet training is important. In some patients behaviour interventions are important. Oral laxatives are the basis of treatment of children with functional constipation, whereas they are contra-indicated in children with solitary encopresis. In both groups, biofeedback training appears to be of little additional benefit. Long-term follow-up of children with functional defecation disorders shows that complaints continue far beyond puberty in many children.

Cathartics↗
PubMedDate not supplied

Assessment and management of pediatric constipation in primary care.

Assessment and management of pediatric constipation is a challenging problem frequently faced by primary care practitioners. The purpose of this article is to offer a review of the literature including the definition of pediatric constipation and the presentation, etiology, and management of this common childhood disorder. Education and anticipatory guidance with children and their families should be included in the treatment regimen to prevent recurrences and promote health maintenance.

Algorithms↗
PubMed1992

Constipation--a sign of a disease to be treated surgically, or a symptom to be deciphered as nonverbal communication?

Constipation is not a sign but a symptom, which is not measurable scientifically. It has emotional components and must be dealt with in a holistic manner. The scientific approach aims only at the physiological derangement and serves to place the complaint in a more objective perspective. An algorithm can be constructed to select treatment including surgery, but there is no gold standard at present because the natural history of the symptoms is unknown. Most physicians confuse normality with epidemiology, neglecting in the process the evolution of mankind in terms of behavior. Constipation now means less than five stools per week, while it used to mean three. Thus, all complaints should be addressed. As for surgery, it should be performed in few, high select patients with no dysfunction other than that in the colon and in conjunction with a fully normal thorough psychological evaluation.

Adult↗
PubMed2004

Management of chronic constipation.

Constipation is a common problem in the United States. Although most individuals do not seek health care for its symptoms, there are still more than 2 million visits to physicians annually for treatment. In this article, the author presents an overview of current diagnostic tools and treatment options for chronic constipation.

Cathartics↗
PubMed2004

[The effect of polyethylene glycol in chronic constipation is not sufficiently evaluated. A systematic literature review].

Five studies compared polyethylene glycol (PEG), an osmotic laxative, with placebo. In two studies the comparison was lactulose and in one study two different doses of PEG 3350 and PEG 4000, respectively were evaluated. PEG is associated with an increase in bowel movement frequency when compared with placebo. There was inadequate evidence to establish whether PEG was superior to lactulose. Data from elderly patients are lacking and data from patients with constipation due to Parkinson's disease, multiple sclerosis or opioid therapy was only evaluated in two very small studies. Severe side-effects with PEG are rare. There are no convincing data regarding the superiority with PEG in flatulence. On the whole there is a real lack of research into treatment of the chronic constipation in adults as well as in the elderly.

Adult↗
PubMed2005

Neostigmine: an alternative treatment for constipation.

Constipation is a common complication of amyotrophic lateral sclerosis (ALS), especially as the disease progresses. While ALS patients may experience disturbed gastrointestinal motility due to the nature of the disease and decreased physical activity, the constipation is not usually caused by mechanical obstruction. Acute colonic pseudo-obstruction (ACPO) is a syndrome characterized by massive dilation of the colon without mechanical obstruction. Recent studies have shown neostigmine may be an effective treatment for ACPO. Through a case study, the author discusses the use of neostigmine and its nursing implications on a patient with ALS.

Aged↗
PubMedDate not supplied

Imperforate hymen presenting with chronic constipation and lumbago: report of one case.

A history of unexplained low back pain associated with chronic constipation in an adolescent girl of menarchal age or in an obviously postmenarchal girl should make one consider an imperforate hymen with hematocolpos. This is a particular important differential diagnosis in the work-up of an adolescent who denies ever having had menses or sexual activity. The case of a girl with an imperforate hymen presenting with a six-month history of chronic constipation and intermittent low back pain is described.

Adolescent↗
PubMed2004

Additional faecal reservoirs or hidden constipation: a link between functional and organic bowel disease.

INTRODUCTION: The study was undertaken to test a hypothesis of coexistence and causality between abdominal and recto-anal symptoms and physical signs. MATERIAL AND METHODS: A random sample of 251 patients was drawn from 645 referred patients from 12th September 1988 to 19th January 1999. Nineteen selected symptoms were recorded; abdominal palpation and ano-rectoscopy were with special reference to identify faecal reservoirs. Barium enema was used to demonstrate colon pathology. After a combined prokinetic regimen, symptoms and signs were reassessed. The study was observational and factor analysis was used to explore the data together with testing after cross tabulations. RESULTS: One hundred and fifty-nine patients were female (63%); neither bloating (64%), abdominal pressure (60%) and pain (26%) nor right iliac fossa tenderness (58%) and faecal mass (42%) and meteorism (33%) were related to age. Patients with additional diverticula and haemorrhoids were significantly older than patients without these lesions. Bloating was found together with a reservoir of faeces in ano-rectum in 62% of patients and 51% had haemorrhoids grade 2 or more and 50% had bloating, faeces in rectum and a right sided palpable abdominal mass (additional faecal reservoir). Among 17 factors explaining 68% of the variance in 45 variables, frequent abdominal and ano-rectal symptoms and physical signs showed substantial correlations to nine factors, indicating that they belong to the same underlying condition. A malignant tumour was found in four patients, polyps in 20 patients, and in 105 patients left sided diverticula were present. After a prokinetic regimen was conducted the dominant symptoms and signs were reduced significantly. CONCLUSIONS: Collectively, the data showed significant correlations between abdominal and anorectal symptoms and signs. Additional faecal reservoirs were demonstrated in the right colon and the rectum, irrespective of defaecation daily. This hidden constipation (faecal retention) gives rise to bloating, pain and right iliac fossa tenderness and mass, and defaecation disorders (functional faecal retention) which was confirmed by a significant reduction in symptoms and physical signs after a propulsive regimen. Also, over the years, the state of hidden constipation seems to bear a cumulative risk of developing organic diseases like diverticula, polyps, haemorrhoids and malignancy.

Adolescent↗
PubMed2005

Alleviating debilitating, chronic constipation with colostomy after appendicostomy: a case study.

Severe chronic constipation is a debilitating condition. Patients not only experience infrequent bowel movements, but also are often frustrated by the sensation of incomplete evacuation; pain; straining; daily use of enemas; and continual concerns regarding diet, fluids, and medications. Diagnostic tests are performed to rule out organic causes of the condition. Common treatment options consist of dietary fiber supplementation, dietary instruction, adequate fluid intake, enemas, and laxatives; additional noninvasive management includes biofeedback training and botulinum toxin type A injections. Surgery is rarely recommended, although a select group of patients may benefit from antegrade continence enema procedure. A female patient presented with a history of long-standing constipation. When antegrade continence enema offered no improvement and other treatment measures failed, she underwent successful laparoscopic-assisted sigmoid resection and end colostomy. This approach may provide options for patients in similar circumstances.

Appendix↗
PubMed2006

[A study of human fecal microbiocenosis by experimental in vitro modeling of constipation].

A study of human fecal microbiocenosis using experimental in vitro modeling of constipation was carried out. The study revealed certain dynamics of the incidence, proportion and ratio of microorganisms isolated from the feces at various stages of cultivation. The character of the changes of these parameters depended on the type of the microorganism. According to the results of the experiment, transitory flora (staphylococci; candidas) begins to disappear within the first day of cultivation. If intestinal evacuation is retarded for more than 2 or 3 days, distortion of the microbiological characteristics of the residential microflora, bifidobacteria and escherichiae, is possible. These processes may lead to a false positive result of dysbiosis analysis. The authors conclude that dysbiotic changes in constipation are caused by fecal retention. That is why correct diagnostics of dysbiosis is possible only after regular everyday stool is reestablished.

Adult↗
PubMed2006

[Video-assisted left colectomy for severe constipation. Description of two cases].

The purpose of this report is to describe two cases involving a 43-year-old man and a 41-year-old woman who underwent laparoscopic surgery for dolichocolon causing severe constipation. In both cases the procedure consisted of left colectomy with colorectal anastomosis. There was no operative mortality or morbidity. The outcome on constipation was good. This study demonstrates the utility of laparoscopy for treatment of dolichocolon in carefully selected patents.

Adult↗
PubMed2006

The pathogenesis of constipation.

The pathogenesis of the constipation that is commonly experienced by cancer patients, especially those with advanced disease, is the result of multiple influences on the control of intestinal motility and fluid handling. These factors include the direct effects of malignancy on gut structure, paraneoplastic neural impairment, biochemical disturbance, and adverse effects of cancer treatments. In addition, the debility and reduced oral intake associated with cancer also contribute, as, perhaps, might the older age of many cancer patients. A detailed understanding of the mechanisms of constipation, especially in association with illness, is lacking, and most treatments remain nonspecific.

Age Factors↗
PubMed2006

Chronic constipation: let symptom type and severity direct treatment.

Increased fiber intake through diet or fiber supplements is an appropriate initial therapy for chronic constipation. Osmotic and stimulant laxatives may be administered to patients who do not respond to more conservative measures if the limitations of these agents are explained. Tegaserod, a selective 5-hydroxytryptamine type 4 (5-HT4) receptor partial agonist, is more effective than placebo at relieving symptoms of chronic idiopathic constipation in patients younger than 65 years of age. Patients with suspected defecation disorders and those with treatment-refractory symptoms should be referred to a gastroenterologist for further evaluation.

Alprostadil↗
PubMed2006

[Painful defecation and chronic functional constipation in children: Diagnosis and treatment].

AIM: The aim of this study was to report our results on the treatment of chronic constipation associated with pain during defecation. METHODS: From January 1999 to January 2004, 60 patients (25 females, 35 males; age range, 6 months to 12 years) who met the ROMA II diagnostic criteria for chronic functional constipation associated with pain on defecation were enrolled in the study. All subjects underwent anorectal manometry to determine rectosphincter inhibitory reflex function. A retraining program for daily defecation, a diet high in fiber and lactulose, and local administration of prilocaine/lidocaine were instituted. At rectal anal endosonography, 7 drug-treatment-resistant patients presented with increased thickness of the internal anal sphincter and received botulin toxin A injection at the sphincter. Because symptoms persisted in 2 of these patients, they received a sphincterectomy. RESULTS: At the end of treatment, 40 (71.4%) of the 56 patients who completed the study had a daily bowel movement without pain; 9 experienced a relapse; in the 2 surgical patients the alveus returned to normal function at 2 and 6 weeks, respectively. CONCLUSIONS: Our treatment strategy breaks the vicious circle of spasm-pain-spasm with use of prolonged analgesic treatment and feces softener over the course of the day. In treatment-resistant patients with functioning rectosphincter reflexes and thickened internal anal sphincter, administration of botulin toxin A may be a valuable aid in place of standard sphincterectomy.

Anal Canal↗