BMJ  2003;327:459-460 (30 August), doi:10.1136/bmj.327.7413.459

Editorial

Constipation and its management

Options go beyond laxatives and include behavioural treatment as well as new drugs

The first 150 words of the full text of this article appear below.

Although slow to emerge, major advances have occurred in understanding the causes and management of constipation. It now receives the attention deserved of a symptom that affects a quarter of the population at some time. Most important is the recognition that different pathophysiological processes can result in the final common symptoms of decreased bowel frequency or impaired rectal evacuation. Different clinical syndromes require different therapeutic approaches.

Bowel frequency is influenced by several factors including intake of dietary fibre, emotional make up, and psychological morbidity. Introspective individuals have a lower bowel frequency and produce less stool than extroverts. Infrequent bowel actions in the absence of symptoms can be regarded as part of the normal spectrum of bowel frequency. Low bowel frequency is more common in women.

Controlled cross sectional studies have shown that psychological morbidity is commonly associated with severe constipation.¹ In some patients it is the key causative factor. Other . . . [Full text of this article]

St Mark's Hospital, Harrow HA1 3UJ (kamm@imperial.ac.uk)

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Rapid Responses:

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constipation and common causes .

dr.manan vasenwala
bmj.com, 29 Aug 2003 [Full text]

Re: constipation and common causes .

Ashleigh O Sinclair
bmj.com, 29 Aug 2003 [Full text]

Think before prescribing Laxatives

Sandeep Buddha
bmj.com, 2 Sep 2003 [Full text]

Death from Constipation

George Alexander Khoury
bmj.com, 4 Sep 2003 [Full text]