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Interferon research abs 1 || Hemoglobin research abs || Stem cell research abs || Nucleic acid research abs || Herpes research abs || Bronchitis research abs || Schizophrenia research abs || Tuberculosis research abs || Pneumonia research abs || Constipation research abs || Laxative research abs

Gastroenterol Clin North Am. 2003 Jun;32(2):659-83.
Constipation: evaluation and treatment.

Rao SS.

Department of Internal Medicine, University of Iowa Carver College of Medicine, 200 Hawkins Drive, Iowa City, IA 52242, USA. satish-raiowa.edu

Constipation is a common clinical problem that comprises a constellation of symptoms that include excessive straining, hard stools, feeling of incomplete evacuation, use of digital maneuvers, or infrequent defecation. Although many conditions, such as metabolic problems, fiber deficiency, anorectal problems, and drugs, can cause constipation, when excluded functional constipation consists of two subtypes: slow-transit constipation and dyssynergic defecation. Some patients with irritable bowel syndrome may exhibit features of both types of constipation. The Rome criteria for functional constipation together with modifications proposed here for dyssynergic defecation may serve as useful guidelines for making a diagnosis. Recent advances in technology, together with a better understanding of the underlying mechanisms, have led to real progress in the diagnosis of this condition. Management options are limited, however, and evidence to support these treatments is only modest. The treatment is primarily medical; surgical options should be reserved for refractory disease and after careful diagnostic work-up. Although laxatives remain the mainstay of therapy, prokinetics that are colon-selective are optimal for treating patients with slow-transit constipation, but they are not yet available for clinical use. Recent controlled trials, however, are promising. Biofeedback therapy is the preferred treatment for patients with dyssynergia, but is not widely available. In the near future, user-friendly biofeedback programs including home therapy may facilitate wider use of these methods for patients with dyssynergic defecation.

online pharmacy ref. source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12858610&dopt=Abstract [PubMed - in process]

Arch Pediatr Adolesc Med. 2003 Jul;157(7):661-4.
Safety of polyethylene glycol 3350 for the treatment of chronic constipation in children.

Pashankar DS, Loening-Baucke V, Bishop WP.

Division of Gastroenterology, Department of Pediatrics, University of Iowa, Iowa City 52242, USA. Dinesh-Pashankaiowa.edu

OBJECTIVES: To assess the clinical and biochemical safety profile of long-term polyethylene glycol 3350 (PEG) therapy in children with chronic constipation and to assess pediatric patient acceptance of PEG therapy. DESIGN: Prospective observational study. SETTING: Pediatric clinics at a referral center.Patients Eighty-three children (44 with chronic constipation, 39 with constipation and encopresis) receiving PEG therapy for more than 3 months. MAIN OUTCOME MEASURES: Clinical adverse effects related to PEG therapy and acceptance and compliance with PEG therapy. Serum electrolyte levels, osmolality, albumin levels, and liver and renal function test results were measured. RESULTS: At the time of evaluation, the mean duration of PEG therapy was 8.7 months, and the mean PEG dose was 0.75 g/kg daily. There were no major clinical adverse effects. All blood test results were normal, except for transient minimal alanine aminotransferase elevation unrelated to therapy in 9 patients. All children preferred PEG to previously used laxatives, and daily compliance was measured as good in 90% of children. CONCLUSIONS: Long-term PEG therapy is safe and is well accepted by children with chronic constipation with and without encopresis.

online pharmacy ref. source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12860787&dopt=Abstract

An Sist Sanit Navar. 2002;25 Suppl 2:123-30.
[Adolescence. Chronic functional constipation. Is this a question of education for health?]

[Article in Spanish]

Magana M.

Medicina del Adolescente, Hospital Nuestra Senora de Gracia, 50012, Zaragoza, Spain. graumnicia.es

Chronic functional constipation is a problem whose frequency in consultation is increasing at adolescent ages, in spite of the family's lack of knowledge of the intestinal habits of their children in these age groups. It normally results in a high number of different complementary tests, the use of medicines, at times in a continuous way, hospital admissions and high costs. It is essential to make a detailed clinical history (in order to look for the underlying causes that produce constipation), to realise an exhaustive physical examination in search of any sign of associated pathology, and to apply effective and satisfactory therapeutic actions. Preventive measures must be a priority; hence educational norms, dietetic norms -while the problem persists- and apprenticeship in health self-care are included. Pharmacological treatment should never be the definitive solution to constipation, nor should it be used in a continuous way.

online pharmacy ref. source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12861263&dopt=Abstract [PubMed]

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