Differential therapy of constipation--a review.

Area of Science:

• Gastroenterology
• Geriatrics
• Pharmacology

Background:

• Constipation is increasingly prevalent in the elderly population.
• It significantly impacts patients' quality of life and can indicate underlying medical issues.
• Often managed by nurses or self-medication, it warrants direct medical evaluation.

Purpose of the Study:

• To outline a clinical approach for diagnosing and managing constipation.
• To differentiate types of constipation, such as slow transit constipation and defecation disturbances.
• To provide a basis for individualized laxative therapy.

Main Methods:

• Review of clinical approaches including medical history and physical examination.
• Utilizing the radiopaque pellets method for differential diagnosis.
• Analysis of laxative mechanisms of action (anti-absorptive, secretagogue, osmotic, filling/swelling agents).

Main Results:

• A systematic approach aids in identifying causes and initiating appropriate therapy.
• Understanding laxative pharmacology is crucial for selecting the correct treatment.
• Chronic constipation requires physician evaluation to rule out treatable causes like hypothyroidism or drug-induced constipation.

Conclusions:

• Differentiated therapy for constipation, including coprostasis, is achievable with a thorough understanding of pathophysiology.
• Physician evaluation is recommended for chronic symptomatic constipation.
• Laxative abuse is rare and typically linked to psychosomatic disorders.