Constipation affects 5-20% of the population and is more common in females. Each year, it accounts for more than 2.5 million patient visits to physicians [1,2]. In 1994, $840 million was spent on laxatives  and in 1985, $354 million was spent on health care services for patients with constipation . Today, the expenditure is likely to be much higher because of escalating health care costs, an increasing array of diagnostic tests and an increasing recognition of this problem. However, in the community, many patients self-treat their “constipation”, often successfully, using either home remedies or laxatives. Hence, those who seek medical help merely constitute the tip of the “constipation iceberg”. Most of these patients have a significant problem, which merits further evaluation.
KeywordsIrritable Bowel Syndrome Anal Sphincter External Anal Sphincter Colon Transit Pelvic Floor Dysfunction
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