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Topic: Constipation, difficult to pass stools

  1. Fact Sheet: Disorders Related to Excessive Pelvic Floor Muscle Tension

    109

    By: Jeanette Tries, PhD, OTR

    Disorders which have excessive pelvic floor muscle activity as their primary feature are often not recognized and diagnosed by physicians. However, millions of people suffer from such disorders and associated symptoms of disabling pain and disruptions in bowel and bladder control. Unfortunately, individuals with these disorders frequently seek help for many years before receiving any explanation for, or relief from their disturbing symptoms. The purpose of this article is to briefly explain the role of the pelvic floor muscles and some symptoms related to the presence of elevated tension in these muscles, and to describe various treatment options available.

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  2. Fact Sheet: Physiological Testing of the Colon, Rectum and Anus

    111

    By: Bruce A. Orkin, MD

    Often a diagnosis of a functional GI disorder can be made based on a history and physical examination. Sometimes exxtensive testing may be needed to find a cause. A review of tests used to examine bowel structure and function.

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  3. Fact Sheet: Biofeedback & Bowel Disorders: Teaching Yourself to Live without the Problem

    112

    By: Mary K. Plummer, OTR, BCIA-PMBD; Jeanette Tries, PhD, OTR

    Biofeedback is a neuromuscular reeducation tool we can use to tell if certain processes in our bodies are working correctly. It is a painless process that uses a computer and a video monitor to display bodily functions that we usually are not aware of. Special sensors measure these functions, which are displayed as sounds we can hear, or as linegraphs we can see on a computer screen. A therapist helps us use this displayed information to modify or change abnormal responses to more normal patterns such as increasing a response, decreasing a response, or learning to coordinate two responses more effectively.

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  4. Fact Sheet: Evaluation and Treatment of Constipation

    118

    By: M. Scott Harris, MD

    Constipation is one of the most common gastrointestinal complaints in the United States. It afflicts approximately 1 in 6 individuals and is responsible for approximately 2.5 million physician visits each year. More than $400 million is spent annually on over-the-counter laxatives; at least 120 of these products are available. The management of constipation includes patient education about bowel function and diet, behavior modification, drug therapy, and infrequently, surgery.

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  5. Fact Sheet: Visceral Sensations and Brain-Gut Mechanisms

    127

    By: Emeran A. Mayer, MD

    Over the past several years, different mechanisms located within the gut, or gut wall have been implicated as possible pathophysiologic mechanisms underlying the characteristic IBS symptoms of abdominal pain and discomfort. The list ranges from altered transit of intestinal gas, alterations in the colonic flora, immune cell activation in the gut mucosa, and alterations in serotonin containing enterochromaffin cells lining the gut. For those investigators with a good memory, these novel mechanisms can be added to an older list of proposed pathomechanisms, including altered gut motility ("spastic colitis") and alterations in mucus secretion.

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  6. Fact Sheet: Functional Abdominal Bloating

    128

    By: David Maxton, MD

    Bloating is a common symptom in irritable bowel syndrome (IBS), particularly in women, although mostly it is a nuisance rather than the most severe aspect of the disease. However, bloating may be the only symptom for some people. A discussion of bloating and tips on managing the condition.

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  7. Fact Sheet: What you can do after. (Anal discomfort and how to deal with it)

    137

    By: W. Grant Thompson, MD, FRCPC

    Symptoms related to this sensitive area can be very troubling, yet many people are reluctant to discuss them. Itching (pruritis ani), painful defecation, stained underwear, spotting of blood, and offensive odor add up to embarrassment, distress, social handicap and anguish. These complaints of anal discomfort are very common. Symptoms may coexist with the irritable bowel syndrome or other functional bowel disease. Diarrhea and constipation may aggravate them. Anal symptoms are not part of these conditions as they may occur independently. They may be due to or associated with many local diseases. Whatever the association, perianal irritation can be treated. Find out how to get help and what to do about it. Reviewed and updated 2009.

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  8. Fact Sheet: Fiber Therapy in IBS and other GI Disorders

    152

    By: James W. Anderson, MD

    Specific food practices may contribute to constipation, diarrhea, bloating, gas, and abdominal pain. Based on our observation and experiences in nutrition research, we will share with you some suggestions for improving bowel function and decreasing symptom severity.

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  9. Fact Sheet: The Lower GI Tract and its Common Functional Disorders:

    158

    By: David S. Greenbaum

    IBS, Chronic Functional Abdominal Pain, Bloating and Gas, Constipation, Diarrhea

    The term "functional" as used in medicine, generally is taken to mean symptoms not accompanied by demonstrable abnormalities on physical examination, blood tests, x-rays, biopsies, endoscopies or other procedures. An overview of common disorders that affect the colon.

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  10. Fact Sheet: Constipation, Colonic Inertia, and Colonic Marker Studies

    159

    By: Eli D. Ehrenpreis, MD

    Constipation is a common symptom. Treatment for constipation often includes lifestyle modifications such as increasing fluid intake, consuming more fiber, and exercising regularly. At times, the symptom of constipation can represent serious medical illnesses such as hypothyroidism or diabetes. Structural abnormalities of the colon, like colonic strictures or other diseases of the colon or rectum, may also cause constipation. It is therefore advisable to report constipation to your physician if it is persistent or difficult to manage. Tests and treatment are described.

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  11. Fact Sheet: Gastrointestinal Motility Disorders of the Small Intestine, Large Intestine, Rectum, and Pelvic Floor

    162

    By: William E. Whitehead, PhD

    The gastrointestinal tract is divided into four distinct parts that are separated by sphincter muscles; these four regions have distinctly different functions to perform and different patterns of motility (contractions). Abnormal motility or abnormal sensitivity in any part of the gastrointestinal tract can cause characteristic symptoms: food sticking, pain, or heartburn in the esophagus; nausea and vomiting in the stomach; pain and bloating in the small intestine; and pain, constipation, diarrhea, and incontinence in the colon and rectum.

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  12. Fact Sheet: Rectocele: Symptoms Include Vaginal Pain or Constipation

    165

    By: Bruce A. Orkin, MD

    A rectocele is a bulge from the rectum into the vagina. Most rectoceles occur in women where the front wall of the rectum is up against the back wall of the vagina. This area is called the rectovaginal septum and may be a weak area in the female anatomy. Other structures may also push into the vagina. A description of causes, symptoms, diagnosis, and treatment.

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  13. Fact Sheet: What is Constipation Anyway?

    170

    By: W. Grant Thompson, MD, FRCPC

    Notions of bowel habit lie in the eyes of the beholders. Constipation is one of the most difficult gut symptoms to define. Patients, physicians, and physiologists have different views of the condition. The difficulty lies in the many, but variably present, features of constipation. Since more than 98% of people have at least 3 bowel movements per week, less is often invoked as abnormal. Many manage happily with less, while others within that range are decidedly uncomfortable with what they believe is constipation. Reviewed and updated 2009.

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  14. Fact Sheet: Difficult to Interpret Intestinal Complaints

    179

    By: W. Grant Thompson, MD, FRCPC

    Disorders of gastrointestinal function such as the irritable bowel syndrome or functional constipation, diarrhea, or bloating are characterized by no structural abnormality. In these cases, diagnosis depends entirely upon the history, and diagnostic tests, if needed at all, are done to rule out inflammations, tumors and other anatomic gut disease. Accurate diagnosis depends upon how accurately the individual describes his or her symptoms, and how skillfully the doctor interprets them. Reviewed and updated 2009.

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  15. Brochure, Fact Sheet: Chronic Constipation: From Evaluation to Treatment

    192

    By: Robert D. Madoff, MD, FACS

    Constipation is a common symptom that affects virtually everyone at some point in their life. Occasional constipaion will generally respond to simple lifestyle measures. But constipation that is chronic or recurrent may indicate the need to see a doctor for evaluation and treatment. The term constipation includes a complex of symptoms related to slow, impaired, difficult, or painful defecation. An in-depth review of causes, diagnosis, and treatments.

    Also available offline as a glossy color brochure (3.5" x 8.5"). Contact IFFGD for details.

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  16. Fact Sheet: Common Questions about Constipation: Myths and Misconceptions

    197

    By: Kenneth G. Mandel, PhD

    Is there a danger from constipation that stool can remain for too long a time period in the colon? Can this cause other disease?

    Can changes in hormones cause constipation?

    Is constipation caused by low intake of fiber or fluid?

    Is the long-term use of stimulant laxatives for constipation unhealthy or unsafe? Are stimulant laxatives habit forming?

    This article addresses various myths and misconceptions about constipation and its treatment. Though most of these issues are well understood by the medical practice community, they persist among the general public and are still promoted by those who are uninformed.

     

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  17. Brochure, Fact Sheet: Bowel Problems Associated with Neurologic Diseases

    198

    By: Arnold Wald, MD, MACG

    Lower bowel symptoms such as constipation and fecal incontinence are not uncommon in patients with neurologic diseases – including multiple sclerosis, diabetes mellitus, spinal cord lesions, and Parkinson's disease – and can have a profoundly negative impact on quality of life. Understanding the causes can assist in planning effective management strategies. Revised and updated 2009.

    Also available offline as a glossy color brochure (3.5" x 8.5"). Contact IFFGD for details.

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  18. Fact Sheet: Dietary Fiber: What is it?

    200

    By: W. Grant Thompson, MD, FRCPC

    Much is published on the benefits of "fiber" in the diet. Nevertheless, there is some confusion over what constitutes dietary fiber. Moreover, some of its proclaimed benefits are controversial. Therefore, it is a challenge to determine if, how much, and what kind of fiber one should take. This article addresses the nature of dietary fiber; its sources; its commonly accepted benefits, especially for the intestinal tract; and how to achieve sufficient daily fiber intake. Reviewed and updated 2009.

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  19. Fact Sheet: A Guide to Managing the Benefits and Risks of Medicines

    202

    By: Information Adapted from FDA Publication FDA

    For many people, taking medication is a regular part of the daily routine, and these medicines are relied upon to treat disease and improve health. Although medicines can make you feel better and help you get well, it's important to know that all medicines, both prescription and over-the-counter, have risks as well as benefits.

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  20. Fact Sheet: Understanding the Quality of Life Impact of Functional Gastrointestinal Disorders

    205

    By: Brennan M. R. Spiegel, MD

    Functional gastrointestinal (G) disorders significantly impact health related quality of life. This impact is obvious to anyone who has a disorder, or to any provider who cares for people with these disorders. In light of this finding, several medical organizations suggest that healthcare providers carefully monitor the health related quality of life of their patients in order to help guide treatment decisions. However, some studies indicate that many (but by no means all) providers do a poor job of addressing their patients' concerns, and accurately assessing the impact of functional GI disorder symptoms on their overall health status. Patients, in turn, become dissatisfied with their care. This article aims to help both provider and patient understand health related quality of life and improve patient care.

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