Functional Constipation: Individualising Assessment and Treatment

AbstractChronic constipation is one of the five most common symptoms seen by gastroenterologist. In the absence of alarm symptoms, a confident symptom-based diagnosis can often be made using the Rome criteria. Three different subtypes have been identified to date: normal transit constipation, defaecatory disorders and slow transit constipation. Differentiation between these subtypes can be made through functional testing using tests such as anorectal manometry with balloon expulsion and a radio-opaque marker test. In general, patients are initially advised to increase their fluid and fibre intake. When these general lifestyle recommendations do not improve patients ’ symptoms, a step-wise and add-on treatment approach should be applied. This review summarises the diagnostic criteria to differentiate functional constipation from other causes of chronic constipation. In addition, current drug treatment options, including discussion of new therapeutic targets a re discussed. Further, practical treatment approaches (choice and dosing), include discussion of combination/augmentation, treatment failure (adherence/expectations), and relapse prevention are mentioned. Finally, treatment and management of pain and bloating aspects are included.
Source: Drugs - Category: Drugs & Pharmacology Source Type: research

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Conclusions: Perception of opioids among patients who take them was either neutral or positive. However, 39.0% patients who have not been prescribed opioids did not want an opioid prescription, citing fear of addiction and side effects as the primary reasons. PMID: 32606268 [PubMed]
Source: Korean Journal of Pain - Category: Anesthesiology Tags: Korean J Pain Source Type: research
SPONSORED POST By SAM HOLLIDAY Medically reviewed by Jenny Blair, MD Gastrointestinal diseases like inflammatory bowel disease (IBD), gastroesophageal reflux disease (GERD), and irritable bowel syndrome (IBS) are more prevalent—and costlier—than many employers realize. Up to 70 million Americans are affected by gastrointestinal (GI) diseases each year—twice as many people as those living with diabetes (34.2 million).[1],[2] Overall direct healthcare costs for GI diseases are estimated to be $136 billion each year in the U.S., more than heart disease ($113bn) and mental health disorders ($99bn...
Source: The Health Care Blog - Category: Consumer Health News Authors: Tags: Health Tech gastrointestinal diseases Oshi Health Sam Holliday Source Type: blogs
Constipation occurs in over 60% of persons with cancer during treatment and in palliative care. Constipation leads to physical and psychological distress and impacts quality of life; however, the evidence on prevention and resolution of symptoms is limited.
Source: Journal of Pain and Symptom Management - Category: Palliative Care Authors: Source Type: research
RARITAN, NJ, June 13, 2020 – The Janssen Pharmaceutical Companies of Johnson &Johnson announced today results from the first randomized Phase 3 study investigating subcutaneous daratumumab[i] in the treatment of patients with newly diagnosed light chain (AL) amyloidosis, a rare and potentially fatal disease.[1],[2] The data demonstrated subcutaneous daratumumab in combination with cyclophosphamide, bortezomib, and dexamethasone (D-CyBorD) resulted in a higher hematologic complete response rate (CR), (53 percent vs. 18 percent [P
Source: Johnson and Johnson - Category: Pharmaceuticals Tags: Innovation Source Type: news
, Martinez J, Cavelier F, Sarret P Abstract Neurotensin (NT) exerts naloxone-insensitive antinociceptive action through its binding to both NTS1 and NTS2 receptors and NT analogs provide stronger pain relief than morphine on a molecular basis. Here, we examined the analgesic/adverse effect profile of a new NT(8-13) derivative denoted JMV2009, in which the Pro10 residue was substituted by a silicon-containing unnatural amino acid silaproline. We first report the synthesis and in vitro characterization (receptor-binding affinity, functional activity and stability) of JMV2009. We next examined its analgesic activity ...
Source: European Journal of Pharmacology - Category: Drugs & Pharmacology Authors: Tags: Eur J Pharmacol Source Type: research
Conclusions: There were several novel covariates found that are seen in the all-cause chronic constipation literature but have not been reported for opioid-induced constipation. Some are modifiable covariates, particularly medication coadministration, which may assist clinicians and researchers in risk stratification efforts when initiating opioid medications. The integration of CMS data supports the robustness of the analysis and may be of interest in the elderly population warranting future examination. PMID: 32318129 [PubMed - in process]
Source: Pain Research and Management - Category: Anesthesiology Authors: Tags: Pain Res Manag Source Type: research
AbstractPurpose of ReviewThe purpose of this review is to give an overview of pelvic floor muscle (PFM) dysfunction in women including evaluation, diagnosis, and treatment.Recent FindingsThe prevalence of PFM dysfunction is thought to be higher in women and may contribute to urinary, defecatory, and sexual dysfunction, as well as chronic pelvic pain.SummaryPFM dysfunction is more prevalent amongst athletes, women who have given birth, and postmenopausal women than the general population. Stress and urge incontinence, urinary frequency and urgency, functional constipation, and fecal incontinence are all symptoms that may re...
Source: Current Physical Medicine and Rehabilitation Reports - Category: Rehabilitation Source Type: research
Conclusions: Stomach pain in geriatric patients with constipation can lead to difficulty in sleeping, loss of appetite, and persistent pain in the stomach. Constipation can be assessed by using posterior anterior and oblique views of the abdominal radiographic projection. Numerous modalities, including pharmacologic therapy (sodium lauryl sulfoacetate enema and lactulose syrup), have been used to treat constipation-related pain. Recently, acupuncture has also been used to treat stomach pain in geriatric patients with constipation. Acupuncture was effective for relieving the current patient's pain and constipation and also ...
Source: Acupuncture in Medicine - Category: Complementary Medicine Authors: Tags: Med Acupunct Source Type: research
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Source: Pain Management Nursing - Category: Nursing Authors: Source Type: research
Discussion The term, cerebral palsy, or CP has gone through many iterations with the first description in 1861 by W.J. Little who described it as “The condition of spastic rigidity of the limbs of newborn children.” The most recent definition is from Rosenbaun et al. in 2007 which states it is “a group of permanent disorders of the development of movement and posture, causing activity limitation, that are attributed to non-progressive disturbances that occurred in the developing fetal or infant brain. The motor disorders of cerebral palsy are often accompanied by disturbances of sensation, perception, cog...
Source: PediatricEducation.org - Category: Pediatrics Authors: Tags: Uncategorized Source Type: news
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