Clinical Pearls
The Compounding Costs of Constipation
Diane Danly, MD HMDC FAAFP
"How are your bowels moving?" This isn't a comfortable subject for our patients, and they are unlikely to bring up the topic of constipation unless we ask.1,2 Constipation is a big player in chronic disease, having the dubious distinction of being the third-most-prevalent symptom in palliative care populations, contributing to suffering and reduced quality of life in up to 87% of our patients.3-5 The absence of an accepted definition of constipation or a universally applied assessment tool further hinders accurate evaluation.3 Most laxatives have not been subjected to high-quality randomized controlled trials.5 And we must consider that the worse the constipation, the more discomfort the patient will experience and the more time-consuming and costly the issue will be to treat.2,4,6,7