Different Classes of Treatments for Constipation
Various surveys report the incidence of constipation to range from 2 to 30%, with one large international survey pegging the number at 12% worldwide. The numbers encompass a wide range and probably reflect fundamental problems in the survey method itself. However, the bottom line is that constipation is a common condition that afflicts a substantial fraction of the population.
The uncertainty of survey results stems partly from the fact that defining constipation is difficult. For example, asked what a normal frequency for passage of stool is, the average person might reply anywhere from every day to every three days. Furthermore, many will complain about other types of symptoms associated with constipation, such as hard feces, or very slow expulsion when sitting on the toilet seat. Such variations confound the interpretation of statistics, giving rise to numbers as low as 2% and as high as 30%.
Diagnosis of disease is followed by the monumental goal of pinning down the primary cause in each patient. Diagnosis is easy if there are many other tell-tale signs, such as those found in patients with irritable bowel syndrome. In another subgroup, patients may suffer from nerve and muscle damage that are the culprits of constipation. But for a very large group, physicians will be unable to find a cause. In this large group, the condition is simply called “idiopathic constipation”.
Often first line therapy for people diagnosed with chronic idiopathic constipation is introduction of high fiber into diet. Recent studies show that fiber and fluids are effective in only a small fraction of patients. Because of the ease and accessibility of high fiber treatment, natural remedies for constipation are quite popular with physicians and patients. Response is expected within two weeks, at which time both parties may decide whether the diagnosis and therapy were successful.
Other types of natural treatments include both lubricant laxatives and herbal supplements such as senna. Herbal and natural supplements are not always safe. The FDA has banned some natural supplements, namely aloe vera and cascara recently, for failure on the part of manufacturers to provide sufficient safety data. However, some other over-the-counter treatments remain available.
There are also a number of prescription-only constipation medications available. Some of these act as laxatives, whereas others are special compounds that modulate the functional properties of the gastrointestinal tract. In recent times, exciting therapies such as biofeedback have also risen to prominence. Expect treatments for constipation to advanced greatly in the next few years.
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