Chronic Constipation means constipation lasting over 6 months. Idiopathic Constipation means constipation with no known cause (not due to other diseases or drugs). On average, Americans eat about 5 to 20 grams of fiber daily, short of the 20 to 35 grams recommended by the American Dietetic Association. Both children and adults eat too many refined and processed foods in which the natural fiber is removed.

Constipation is one of the most common gastrointestinal complaints in the United States, resulting in about 2 million doctor visits annually. However, most people treat themselves without seeking medical help, as is evident from the millions of dollars Americans spend on laxatives each year. If you are constipated often, it may mean your digestive system is working more slowly than normal. This may be due to the way your system reacts to changes in serotonin. Serotonin is a chemical that your body produces naturally. In the gastrointestinal (GI) tract (where 95 percent of the body's serotonin is found), it helps the digestive system work normally.

The most common cause of constipation is a diet low in fiber found in vegetables, fruits, and whole grains and high in fats found in cheese, eggs, and meats. People who eat plenty of high-fiber foods are less likely to become constipated. People who are constipated may find it difficult and painful to have a bowel movement. Other symptoms of constipation include feeling bloated, uncomfortable, and sluggish.

Zelnorm increases the movement of stools (bowel movement) through the bowels. Zelnorm does not cure chronic idiopathic constipation. Zelnorm increases bowel movements and reduces straining, bloating and abdominal discomfort in the chronic idiopathic constipation sufferers.

If you stop taking Zelnorm, your symptoms may return within 1-2 weeks. Zelnorm is a medicine for the treatment of patients (men and women) less than 65 years of age with chronic idiopathic constipation. Zelnorm has not been shown to work in patients (men and women) with chronic idiopathic constipation who are 65 years of age or older. You should not start taking Zelnorm if-
• You have bad kidney or liver disease.
• You now have diarrhea or have diarrhea often.
• You have ever had bowel obstruction (intestinal blockage), symptomatic gallbladder disease, or abdominal adhesions causing pain and/or intestinal blockage.
• You are allergic to tegaserod maleate, an active ingredient of Zelnorm.

Another drug of choice for idiopathic constipation is Cisapride. Cisapride appears to be useful as therapy for chronic constipation that is not associated with underlying organic abnormalities or pregnancy and that is refractory to other treatments, such as increased dietary fiber intake or bulk laxatives. Dosages of cisapride that have demonstrated efficacy in chronic constipation range from 5 mg po tid to 20 mg po bid. Treatment for 8-12 weeks may be necessary for an optimal effect to occur.

People with chronic constipation caused by anorectal dysfunction can use biofeedback to retrain the muscles that control release of bowel movements. Biofeedback involves using a sensor to monitor muscle activity that at the same time can be displayed on a computer screen, allowing for an accurate assessment of body functions. A health care professional uses this information to help the patient learn how to use these muscles. Most people with mild constipation do not need laxatives. However, doctors may recommend laxatives for a limited time for people with chronic constipation. People who are dependent on laxatives need to slowly stop using them. A doctor can assist in this process. In most people, this restores the colon's natural ability to contract.

 

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