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Medical Treatment of Constipation

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Book cover Constipation

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Conclusion

In a community practice, uncomplicated constipation should be approached in a stepwise manner. Although most patients may have their own methods to deal with acute problems, they occasionally need a one-time oral cathartic or large-volume enema in the beginning of treatment, to start with a “clean slate.” In these situations, prior to treatment, confirmation of constipation is usually easily accomplished by reviewing an abdominal x-ray.

Most patients’ symptoms of constipation can be treated with daily fiber supplements and behavior modification. Of the remaining patients, many respond to rectally administered glycerin suppositories, enemas, or the judicious use of an oral stimulant, such as magnesium or senna.

For those continuing with symptoms despite conservative management, the practitioner will have to decide whether to proceed with prescription therapy such as polyethylene glycol or Tegaserod, or refer the patient for physiologic-anatomic testing with marker studies and defecography.

In the near future, effective therapy for narcotic-induced constipation will likely be available. Until then, aggressive, nonspecific therapy accompanied by minimization or elimination of the offending substance is warranted.

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Authors and Affiliations

  1. Department of Gastroenterology, Cleveland Clinic-Florida, Weston, FL, USA

    Raymond B. Sandler MD & Ramu Raju MD

  2. Department of Colorectal Surgery, Cleveland Clinic-Florida, Weston, FL, USA

    Benjamin Person MD

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  1. Raymond B. Sandler MD
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Editor information

Editors and Affiliations

  1. Cleveland Clinic Florida, Weston, FL, USA

    Steven D. Wexner MD, FACS, FRCS, FRCS (Ed) (21st Century Oncology Chair in Colorectal Surgery Chairman, Department of Colorectal Surgery Chief of Staff, Professor of Surgery and Clinical Professor of Surgery) (21st Century Oncology Chair in Colorectal Surgery Chairman, Department of Colorectal Surgery Chief of Staff, Professor of Surgery and Clinical Professor of Surgery)

  2. Ohio State University Health Sciences Center at the Cleveland Clinic Foundation, Columbus, OH, USA

    Steven D. Wexner MD, FACS, FRCS, FRCS (Ed) (21st Century Oncology Chair in Colorectal Surgery Chairman, Department of Colorectal Surgery Chief of Staff, Professor of Surgery and Clinical Professor of Surgery) (21st Century Oncology Chair in Colorectal Surgery Chairman, Department of Colorectal Surgery Chief of Staff, Professor of Surgery and Clinical Professor of Surgery)

  3. University of South Florida College of Medicine, Tampa, FL, USA

    Steven D. Wexner MD, FACS, FRCS, FRCS (Ed) (21st Century Oncology Chair in Colorectal Surgery Chairman, Department of Colorectal Surgery Chief of Staff, Professor of Surgery and Clinical Professor of Surgery) (21st Century Oncology Chair in Colorectal Surgery Chairman, Department of Colorectal Surgery Chief of Staff, Professor of Surgery and Clinical Professor of Surgery)

  4. Charles E. Schmitt College of Science, Florida Atlantic University, Boca Raton, FL, USA

    Steven D. Wexner MD, FACS, FRCS, FRCS (Ed) (21st Century Oncology Chair in Colorectal Surgery Chairman, Department of Colorectal Surgery Chief of Staff, Professor of Surgery and Clinical Professor of Surgery) (21st Century Oncology Chair in Colorectal Surgery Chairman, Department of Colorectal Surgery Chief of Staff, Professor of Surgery and Clinical Professor of Surgery)

  5. University of Hull, Cattingham, UK

    Graeme S. Duthie MD, FRCS, FRCSEd (Reader in Surgery and Honorary Consultant Colorectal Surgeon) (Reader in Surgery and Honorary Consultant Colorectal Surgeon)

  6. Hull and East Yorkshire NHS Trust, Castle Hill Hospital, Cottingham, UK

    Graeme S. Duthie MD, FRCS, FRCSEd (Reader in Surgery and Honorary Consultant Colorectal Surgeon) (Reader in Surgery and Honorary Consultant Colorectal Surgeon)

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Sandler, R.B., Person, B., Raju, R. (2006). Medical Treatment of Constipation. In: Wexner, S.D., Duthie, G.S. (eds) Constipation. Springer, London. https://doi.org/10.1007/978-1-84628-275-1_14

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  • DOI: https://doi.org/10.1007/978-1-84628-275-1_14

  • Publisher Name: Springer, London

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  • Online ISBN: 978-1-84628-275-1

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