Chronic constipation

When should I seek medical care for chronic constipation?

If the main problem is straining to push the stool out, chronic constipation should probably be evaluated early. This difficulty might be due to pelvic floor dysfunction, and the treatment of choice is biofeedback training, not laxatives. If the constipation is not responding to the simple measures discussed previously with the addition of hyper-osmolar laxatives or milk of magnesia, it is time to consult a physician for an evaluation. If a primary doctor is not comfortable performing the evaluation or does not have confidence in doing an evaluation, he or she should refer the patient to a gastroenterologist. Gastroenterologists evaluate constipation frequently and are very familiar with the diagnostic testing described previously.What's new in the treatment of constipation ?Each part of the intestine (stomach, small intestine, and colon) has a network of nervesthat controls its muscles. A great deal of research is being done in orderto gain an understanding of how these nerves control each other and ultimately themuscles. Much of this research involves the study of neurotransmitters. This research is allowing scientists to develop drugs that stimulate(and inhibit) the various nerves of the colon which, in turn, cause the musclesof the colon to contract and propel the colonic contents. Such drugs have greatpotential for the treatment of constipation that is due to colonic inertia. Thefirst of these drugs is in clinical trials and is likely to be available soon.These drugs are an exciting development because they offer a new treatment fora difficult-to-treat form of chronic constipation.