Normal Transit Constipation

Constipated patients with normal colon transit and normal anorectal function often misperceive bowel frequency and exhibit increased psychological distress. It is important to reassure these patients that there is no evidence of abnormal function of the colon or rectum. Patients should be educated to increase fluid and fiber intake, take advantage of gastrocolonic responses, and avoid excessive use of laxatives. We often screen these patients for underlying anxiety, depression or other psychological distress using a previously validated psychological symptom form, the SCL-90R. Pharmacotherapy to reduce underlying anxiety or depression may be helpful in some individuals.

Colonic transit (CTS), Anorectal manometry with balloon expulsion (ARM)

Normal CTS Normal ARM

Reassurance Education

Normal CTS Normal ARM

Reassurance Education

Constipation Management Algorithm

FIGURE 75-1. Diagnostic and treatment algorithm for severe constipation.

Constipation Prescription

Constipation Prescription

Did you ever think feeling angry and irritable could be a symptom of constipation? A horrible fullness and pressing sharp pains against the bladders can’t help but affect your mood. Sometimes you just want everyone to leave you alone and sleep to escape the pain. It is virtually impossible to be constipated and keep a sunny disposition. Follow the steps in this guide to alleviate constipation and lead a happier healthy life.

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