TY - JOUR
T1 - Primary care management of chronic constipation in asia
T2 - The anma chronic constipation tool
AU - Gwee, Kok Ann
AU - Ghosha, Uday C.
AU - Gonlachanvit, Sutep
AU - Chua, Andrew Seng Boon
AU - Myung, Seung Jae
AU - Rajindrajith, Shaman
AU - Patcharatrakul, Tanisa
AU - Choi, Myung Gyu
AU - Wu, Justin C.Y.
AU - Chen, Min Hu
AU - Gong, Xiao Rong
AU - Lu, Ching Liang
AU - Chen, Chien Lin
AU - Pratap, Nitesh
AU - Abraham, Philip
AU - Hou, Xiao Hua
AU - Ke, Meiyun
AU - Ricaforte-Campos, Jane D.
AU - Syam, Ari Fahrial
AU - Abdullah, Murdani
PY - 2013/4
Y1 - 2013/4
N2 - Chronic constipation (CC) may impact on quality of life. There is substantial patient dissatisfaction; possible reasons are failure to recognize underlying constipation, inappropriate dietary advice and inadequate treatment. The aim of these practical guidelines intended for primary care physicians, and which are based on Asian perspectives, is to provide an approach to CC that is relevant to the existing health-care infrastructure. Physicians should not rely on infrequent bowel movements to diagnose CC as many patients have one or more bowel movement a day. More commonly, patients present with hard stool, straining, incomplete feeling, bloating and other dyspeptic symptoms. Physicians should consider CC in these situations and when patients are found to use laxative containing supplements. In the absence of alarm features physicians may start with a 2-4 week therapeutic trial of available pharmacological agents including osmotic, stimulant and enterokinetic agents. Where safe to do so, physicians should consider regular (as opposed to on demand dosing), combination treatment and continuous treatment for at least 4 weeks. If patients do not achieve satisfactory response, they should be referred to tertiary centers for physiological evaluation of colonic transit and pelvic floor function. Surgical referral is a last resort, which should be considered only after a thorough physiological and psychological evaluation.
AB - Chronic constipation (CC) may impact on quality of life. There is substantial patient dissatisfaction; possible reasons are failure to recognize underlying constipation, inappropriate dietary advice and inadequate treatment. The aim of these practical guidelines intended for primary care physicians, and which are based on Asian perspectives, is to provide an approach to CC that is relevant to the existing health-care infrastructure. Physicians should not rely on infrequent bowel movements to diagnose CC as many patients have one or more bowel movement a day. More commonly, patients present with hard stool, straining, incomplete feeling, bloating and other dyspeptic symptoms. Physicians should consider CC in these situations and when patients are found to use laxative containing supplements. In the absence of alarm features physicians may start with a 2-4 week therapeutic trial of available pharmacological agents including osmotic, stimulant and enterokinetic agents. Where safe to do so, physicians should consider regular (as opposed to on demand dosing), combination treatment and continuous treatment for at least 4 weeks. If patients do not achieve satisfactory response, they should be referred to tertiary centers for physiological evaluation of colonic transit and pelvic floor function. Surgical referral is a last resort, which should be considered only after a thorough physiological and psychological evaluation.
KW - Asia
KW - Constipation
KW - Management
KW - Physicians
KW - Primary care
UR - http://www.scopus.com/inward/record.url?scp=84876732846&partnerID=8YFLogxK
U2 - 10.5056/jnm.2013.19.2.149
DO - 10.5056/jnm.2013.19.2.149
M3 - Article
AN - SCOPUS:84876732846
SN - 2093-0879
VL - 19
SP - 149
EP - 160
JO - Journal of Neurogastroenterology and Motility
JF - Journal of Neurogastroenterology and Motility
IS - 2
ER -