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Reged: 12/09/02
Posts: 7677
Loc: Seattle, WA
Most important barriers to the optimal management of patients with IBS-C and chronic constipation
      12/01/06 01:23 PM

From Medscape Gastroenterology

Expert Interview

Advances in the Treatment and Understanding of Chronic Constipation and IBS-C: An Expert Interview With Lawrence R. Schiller, MD

Editor's Note:
Irritable bowel syndrome with constipation (IBS-C) and chronic constipation, two of the most common functional disorders of the gut, place a considerable burden on patients and society alike. Indeed, symptoms of both of these gastrointestinal motility disorders are chronic, sometimes severe, and often respond poorly to traditional therapeutic strategies. Inadequate therapy can lead to reduced quality of life, polypharmacy, and increased utilization of healthcare resources. Medscape spoke with Lawrence R. Schiller, MD, Program Director, Gastroenterology Fellowship, Baylor University Medical Center, Dallas, Texas, to discuss the clinical impact of these functional bowel disorders, with a view toward current and emerging therapies, as framed by data presented during the American College of Gastroenterology (ACG) 2006 Annual Scientific Meeting and Postgraduate Course.

Medscape: Given the current state of the field, what do you perceive are the most important barriers to the optimal management of patients with IBS-C and chronic constipation?

Dr. Schiller: Currently, the greatest barriers to optimal management of functional disorders, in general -- and chronic constipation and IBS-C, in particular -- are recognition by patients that something can be done to help their chronic symptoms and recognition by physicians that their patients have these disorders and that more can be done for them. The first limits the number of patients who come to physicians to avail themselves of treatment, and the second limits the application of modern treatments to this group of patients.

For example, we know from good population surveys that approximately 15% of the adult population in the United States meet the criteria for chronic constipation,[1] and that almost half of these individuals are unhappy with the treatments that they have been using. However, only a fraction of this group consults with physicians about constipation.[2] This means that many patients have unmet needs with regard to their bowel habits.

Likewise, we now have agents that can improve symptoms -- and quality of life -- in up to 70% of these constipated patients; however, physicians fail to recognize the presence of the disorder, its impact on patients, and the fact that traditional remedies leave many patients suffering with symptoms.

Medscape Gastroenterology. 2006;8(2) ©2006 Medscape

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