Chronic constipation often is associated with symptoms that negatively affect patients' daily lives, as well as with frequent use of the health care system. At the recent Digestive Diseases Week conference, B. Martin, PharmD, and colleagues demonstrated the high direct costs associated with constipation (not including OTC and prescription drugs) in outpatient and inpatient settings. The results showed that 2.7 million physician visits were made in 2001 where constipation was the primary diagnosis or reason for the consultation: 1,838,493 visits to physician offices, 297,927 visits to hospital outpatient centers, 555,432 visits to the emergency room, and 38,361 inpatient visits. The annual cost totaled $235 million, 55% of which was incurred in the inpatient setting.
G. Singh, MD, and colleagues demonstrated that patients with constipation are more likely to experience complications and comorbidities. In this study, patients with constipation were compared with a random 20% sample of all MediCal enrollees without constipation. Patients with constipation were more likely to experience comorbid irritable bowel syndrome and constipation-associated complications such as impaction, fissures, and volvulus.