Chronic constipation with associated comorbid conditions: a physician survey on clinical perspectives on its diagnosis and management

Rakesh  Kumar; S. R. Ramakrishnan; Ashwin Kulkarni

doi:10.18203/2349-3933.ijam20232834

Authors

Rakesh Kumar Department of Internal Medicine, Indraprastha Apollo Hospital, New Delhi, India
S. R. Ramakrishnan Department of Medicine, Sri. Ramandra Medical College, Chennai, Tamil Nadu, India
Ashwin Kulkarni Department of General Medicine, Ramaiah Medical College, Bengaluru, Karnataka, India

DOI:

https://doi.org/10.18203/2349-3933.ijam20232834

Keywords:

Chronic constipation, Comorbidities, Laxatives, Liquid paraffin, Milk of magnesia, Sodium picosulfate

Abstract

Background: This survey aimed to investigate physicians’ perspectives on chronic constipation in patients with comorbidities, diagnosis and management of CC, and preferred laxatives used for treating CC in these patients.

Methods: A 32-item, questionnaire-based online survey was conducted among 243 consulting physicians to gather information about CC with comorbidities, diagnosis and management strategies, and preferred laxatives.

Results: The survey showed that 10%-39% of patients experienced CC for >3 months as reported by 61.7% of physicians, with diabetes being the most common comorbid condition. Patient noncompliance (93.8%) was identified as the main factor affecting management outcomes. The most preferred laxative by physicians in adult patients and the elderly was the combination of liquid paraffin+MOM+sodium picosulfate. The primary parameters considered by physicians when choosing a laxative were efficacy and tolerability. The laxative containing liquid paraffin + MOM + sodium picosulfate was reported to be effective for overnight relief by 44.9% of physicians in 60%-89% of patients. Physicians largely opined that side effects such as nausea/vomiting, abdominal cramps/pain, and anal seepage/ incontinence occurred in <1% of patients treated with liquid paraffin+MOM+sodium picosulfate.

Conclusions: Clinical features aid in diagnosing CC and physicians prioritize treatment effectiveness when selecting laxatives. The participating physicians opined that combination laxatives consisting of liquid paraffin+MOM+sodium picosulfate are effective and well-tolerated for managing CC in patients with comorbidities. Hence, it is essential to consider their use for effective management of CC with comorbidities.

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