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Drugs for Treatment of Constipation-Predominant IBS01:21

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Pharmacological therapies for IBS-C are designed to alleviate abdominal discomfort and enhance bowel function. In patients with IBS-C, fiber supplements may help soften stools and decrease straining, but may also lead to increased gas production and bloating. Osmotic laxatives like milk of magnesia are frequently used to soften stools and increase stool frequency in IBS-C patients. In addition, two drugs approved for use in severe IBS-C adult cases are linaclotide (Linzess) and lubiprostone...
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Chronic Bowel Disorders: Introduction01:17

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Chronic bowel diseases are a group of long-term conditions affecting the digestive tract, characterized by inflammation and damage to the gut lining. These conditions primarily include irritable bowel syndrome and inflammatory bowel disease.
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Surgical interventions for inflammatory bowel disease (IBD), which includes ulcerative colitis and Crohn's disease, are essential in managing symptoms and addressing complications. The selection of surgical procedures is contingent upon the specific conditions and complications that stem from these illnesses.
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Drugs Affecting GI Tract Motility: Other Laxatives01:20

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Laxatives are primarily used to alleviate constipation, a common gastrointestinal disorder characterized by infrequent bowel movements and difficulty passing stools. They work by various mechanisms to increase the volume or frequency of bowel movements. The primary modes of action of laxatives include increasing stool bulk, softening the stool, stimulating intestinal motility, and osmotically drawing water into the intestines.
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Evaluating the rectum and anus plays a crucial role in conducting a thorough physical examination of the gastrointestinal system. Although it may be uncomfortable and often embarrassing for the patient, it holds immense diagnostic value, particularly in detecting gastrointestinal diseases and abnormalities. This guide will explain how to perform this assessment using inspection and palpation methods.
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Laxatives enhance bowel movements and alleviate constipation. They augment the stool's bulk, stimulate intestinal muscle contractions, draw water into the intestines, or soften the stool. There are five key types of laxatives: bulk laxatives, stimulant laxatives, osmotic laxatives, stool softeners, and lubricant laxatives.
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Chronic Constipation: Gastroenterohepatologist's Approach.

Tomica Milosavljevic1, Dusan D Popovic2,3, Dragana Danilo Mijac2,3

  • 1General Hospital "Euromedik,", Belgrade, Serbia.

Digestive Diseases (Basel, Switzerland)
|May 4, 2021
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Summary

Constipation affects 16% of people and requires a thorough evaluation. Treatment starts with lifestyle changes, progressing to medications or surgery for severe cases.

Keywords:
Alarm symptomsConstipationFunctional bowel disordersLaxativesProkinetics

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Area of Science:

  • Gastroenterology
  • Internal Medicine

Background:

  • Constipation is a prevalent gastrointestinal disorder, affecting approximately 16% of the population.
  • It can be classified as either primary or secondary in nature.

Purpose of the Study:

  • To outline the diagnostic and therapeutic strategies for managing constipation.
  • To emphasize the importance of a systematic approach in clinical practice.

Main Methods:

  • Initial assessment involves a detailed medical history and physical examination.
  • Diagnostic procedures include laboratory tests, endoscopy, radiology, and physiological assessments like anorectal manometry and defecography.
  • Therapeutic options encompass lifestyle modifications, pharmacotherapy, biofeedback, and surgical interventions.

Main Results:

  • A comprehensive history and physical exam are crucial for identifying alarm symptoms and secondary causes, particularly drug-induced constipation.
  • Lifestyle modifications are the first line of treatment.
  • Pharmacological options include bulk/osmotic laxatives, lubiprostone, and linaclotide, used sequentially based on treatment response.

Conclusions:

  • The management of constipation hinges on a stepwise diagnostic and therapeutic approach.
  • Non-operative management, including lifestyle changes and pharmacotherapy, is the mainstay of treatment.
  • Surgical intervention is reserved for refractory cases with confirmed delayed intestinal transit.