Is exercise effective for constipation?

I recently presented a clinical scenario about a patient of mine named Brenda, in Constipation and Cramping: A Slam Dunk Diagnosis? This 35 year old woman came to me with symptoms that have been going on for a year already. I asked for reader feedback about my administration of Brenda.

I appreciate the comments I’ve received regarding this issue. The most common suggestion was to encourage Brenda to exercise, and Systematic review of randomized clinical trials Published in 2019 supports this recommendation. This review included nine studies with a total of 680 participants, and the overall effect of exercise was a twofold improvement in symptoms associated with Constipation. Walking was the most common exercise intervention, and along with qigong (which combines posture, breathing, and meditation), these two forms of exercise were effective in improving constipation. However, the only study that evaluated resistance training failed to demonstrate a significant effect. Importantly, the reviewers considered the collective research to be at high risk of bias.

The exercises will likely help Brenda, although some brainstorming may be necessary to help her fit the exercises into her busy schedule. Another suggestion focused on the risks you are exposed to colorectal cancerCook and Popock have astutely observed that colorectal cancer is increasingly prevalent among adults in early middle age. This stands in contrast to the steady decline in The prevalence of colorectal cancer among adults in the United States At the age of 65 years or older. While colorectal cancer decreased by 3.3% annually among older adults in the United States from 2011 to 2016, there was a reversal of this positive trend among individuals ages 50 to 64, with rates increasing by 1% annually.

The increase in the incidence of colorectal cancer among adults aged 50 to 64 years has exceeded the increase among adults aged less than 50 years, who experienced a 2.2% increase in the incidence of colorectal cancer annually between 2012 and 2016. Previously, the motivation was Behind the increase in colorectal cancer among early middle-aged adults is higher rates rectal cancerMore recently, however, this trend has included higher rates of proximal and distal colon adenomas. In 2020, 12% of new colorectal cancer cases were expected to be among individuals under 50 years of age.

So how do we act in this context in Brenda’s case? Its history does not indicate any explicit warning signs of cancer. The history did not address a family history of gastrointestinal symptoms or colorectal cancer, an important omission.

Although the number of cancer cases among people under 50 years of age may be rising, the overall prevalence of colorectal cancer among younger adults is well below 1%. At age 35, it is not necessary to evaluate Brenda for colorectal cancer. However, persistent or worsening symptoms may lead to referral colonoscopy Later.

Finally, let’s talk about how to manage Brenda’s case in practice, given that there are many options. I’ll start with her lifestyle recommendations, including regular exercise, adequate sleep, and everything she can achieve on the FODMAP diet. I would also recommend psyllium As soluble fiber and expect these changes will help her with constipation. But it may be less effective in the case of abdominal cramps, so I also recommend Peppermint oil at this time.

If Brenda sticks to these recommendations, she is very likely to get better. If you don’t, I’ll be more worried about worrying and depression which complicates her illness. Treating these disorders can make a big difference.

In addition, if there is an insufficient response to the initial treatment, I will start linaclotide or lubiprostone. Plelicanides It is another reasonable option. At this point, I would also consider a referral to a gastroenterologist for a recalcitrant case and would definitely point out if one of these specific treatments failed in Brenda. It can mimic conditions such as pelvic floor weakness irritable bowel syndrome With constipation and maturity.

However, I really think Brenda would feel better. Thanks for all the insightful and interesting comments. It is easy to see how we are all invested in improving patients’ lives.

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