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General practice Terapia 2018, 6 ( 365 ) :  68  -  73

Constipation – a common problem in the general practitioner’s office

Summary: Constipation is one of the common disorders that patients report to family physicians. This problem is experienced by 30% of the population at some point in their life. It is defined as fewer than three bowel movements during the week. In the United States general practitioners prescribe laxatives for even up to 2-3 million patients per year. In nursing homes this disorder affects even up to 67% of residents. The organic etiology of constipation is rarely demonstrated. The most common cause of functional constipation associated with stomach pain, is IBS-C (constipation). Frequently, serious causes of constipation may include obstruction of the distal colon due to colorectal cancer, particularly in the population aged over 50 or in patients with genetic disorders. Chronic constipation is a very common problem in patients with diabetes, affecting about 30% of them. The diagnostic process requires careful assessment of the patient's history, per rectum examination, and in some cases also endoscopy. The first stage of treatment is non-pharmacological therapy, including regular physical exercise, increased fluid intake, and regular meals with high fibrin content. Among pharmaceuticals, the most commonly used are osmotic laxatives such as carbohydrates (sorbitol, lactulose) or polyethylene glycol (PEG). However, laxative drugs generate enormous costs and are associated with a wide range of side effects. It is therefore necessary to seek new methods for treating constipation.
Keywords: constipation, irritable bowel syndrome, lactulose, lactoferrin

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