Chronic constipation often is associated with symptoms that negatively affectpatients' daily lives, as well as with frequent use of the health care system. At therecent Digestive Diseases Week conference, B. Martin, PharmD, and colleaguesdemonstrated the high direct costs associated with constipation (notincluding OTC and prescription drugs) in outpatient and inpatient settings. Theresults showed that 2.7 million physician visits were made in 2001 where constipationwas the primary diagnosis or reason for the consultation: 1,838,493 visitsto physician offices, 297,927 visits to hospital outpatient centers, 555,432 visitsto 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 constipationare more likely to experience complications and comorbidities. In this study,patients with constipation were compared with a random 20% sample of allMediCal enrollees without constipation. Patients with constipation were morelikely to experience comorbid irritable bowel syndrome and constipation-associatedcomplications such as impaction, fissures, and volvulus.