But constipation can also be a side effect of other health problems, Rao explained. Many medications, including painkillers and antidepressants, can cause constipation, for example. And, the NIDDK noted, certain neurological disorders, such as Parkinson's disease; metabolic and endocrine conditions, including diabetes; and systemic disorders, such as Lupus, also can cause problems by slowing the movement of stool through the colon, rectum or anus.
For some people, constipation is the direct or "primary" result of colonic nerve or muscle dysfunction. This group of people includes patients with "dissynergy defecation," a problem that has only been recognized in the last 15 years, Rao said.
"The problem is that the individual has the inability to coordinate the pelvic floor muscles and anorectal muscles to evacuate stool, so many of them have a sense of stooling, but they can't pass, or they only pass small amounts, or incompletely and so on," he said.
Rao and his colleagues recently examined a technique for teaching these patients to improve bowel function. The study, published in the journal Clinical Gastroenterology and Hepatology, compared the use of biofeedback therapy with either sham biofeedback sessions or standard treatments consisting of diet, exercise and laxatives. The biofeedback group came out "far, far superior" to the other two groups, he reported.
Dr. Henry P. Parkman, a professor of medicine and director of the GI Motility Laboratory at Temple University School of Medicine in Philadelphia, said he uses biofeedback -- a form of complementary medicine in which the patient uses the mind to control the body -- quite a bit in his own practice. "It has a response rate of 50 to 75 percent," he said.
Another type of "primary" constipation, called "slow-transit constipation," takes patie
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