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01-06-2014 | Original Article

Management of chronic constipation in general practice

Authors: M. Bellini, D. Gambaccini, S. Salvadori, C. Tosetti, M. T. Urbano, F. Costa, P. Monicelli, M. G. Mumolo, A. Ricchiuti, N. De Bortoli, S. Marchi

Published in: Techniques in Coloproctology | Issue 6/2014

Abstract

Background

Chronic constipation is often diagnosed and treated by general practitioners (GPs). The aim of the study was to evaluate the management of constipation by a cohort of Italian GPs.

Methods

Over the course of 1 month, 41 GPs recorded tests and therapies suggested to patients complaining of chronic constipation. They were classified according to the Rome III criteria as constipated irritable bowel syndrome (C-IBS), functional constipation (FC), or “self-perceived constipation” (SPC) (not consistent with the Rome criteria).

Results

The most frequently prescribed tests for the 229 patients (147 FC, 50 C-IBS, 32 SPC) were routine blood tests (59.3 %), abdominal ultrasounds (37.2 %), thyroid function (36.7 %), fecal occult blood tests (36.7 %), and tumor markers (35 %). Patient sex and age, GP age, and whether the diagnosis was new influenced the GP’s request, but FC, C-IBS, or SPC status did not. Dietary suggestions (81.9 %), fiber supplements (59.7 %), reassurance (50.9 %), and laxatives (30.5 %) were the most frequently prescribed treatments. Antispasmodics were more frequently suggested for C-IBS patients; dietary suggestions, fiber, and enemas were more frequently prescribed in SPC patients. Patient and GP age and whether the diagnosis was new influenced the GP’s choice of treatment.

Conclusions

The Rome III criteria do not influence diagnostic strategies and only slightly influence therapeutic strategies of GPs. Other factors (age, gender, new or old diagnosis) have more influence on GPs choice of investigations and treatment.

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Title: Management of chronic constipation in general practice
Authors: M. Bellini
D. Gambaccini
S. Salvadori
C. Tosetti
M. T. Urbano
F. Costa
P. Monicelli
M. G. Mumolo
A. Ricchiuti
N. De Bortoli
S. Marchi
Publication date: 01-06-2014
Publisher: Springer Milan
Published in: Techniques in Coloproctology / Issue 6/2014
Print ISSN: 1123-6337
Electronic ISSN: 1128-045X
DOI: https://doi.org/10.1007/s10151-013-1093-9

At a glance: The STEP trials

Springer Medicine

Management of chronic constipation in general practice

Abstract

Background

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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