Serious Toll of Chronic Constipation Overlooked
GI Society Patient Survey
Chronic idiopathic constipation, which affects far more women than men, can be extremely debilitating. While it is normal to have a bowel movement anywhere from three times a day to three times a week, a person experiencing chronic idiopathic constipation has hard or lumpy stool that is very difficult to pass. Idiopathic means there is no known cause. Stool can remain in the bowel for more than a week and the buildup within the colon causes unbearable pelvic and abdominal pressure and pain, making it difficult to bend, sit down, have sexual relations, and even to walk. Other symptoms include poor appetite, back pain, and general malaise. The usual methods to relieve occasional constipation (e.g., high-fibre diets, laxatives, enemas) do not work for these patients. Convinced there is no solution for their illness, some of these individuals begin to withdraw from society.
As part of our patient advocacy work, the GI Society is conducting an ongoing survey for women with chronic idiopathic constipation regarding their experiences using Resotran™, a promising newer treatment for this patient group. It is challenging to convince government decision-making bodies and others of the severity of chronic constipation, a socially-stigmatized illness, as many misunderstand it and trivialize the impact it has on a person’s ability to function. While most individuals have had an episode of constipation that resolved easily, many can’t imagine an unrelenting situation, and underestimate the seriousness of chronic constipation.
Most complications of chronic idiopathic constipation result from the intense straining needed to pass stool. These include hemorrhoids, anal fissures, diverticular disease, rectal bleeding, and rectal prolapse. When treatment does not provide effective relief, patients require more frequent use of hospital resources, increasing the public healthcare burden.
To date, we have heard from twenty-four women, almost half of whom completed the survey fully. Before treatment with Resotran™, all of the women who responded to the open-ended questions reported constant pain and bloating, as well as the need to be in constant proximity to a washroom. Without effective treatment, patients are often unable to do simple errands away from home or participate in social and professional outings. Patients say it is difficult even to sit comfortably at home, and sexual intimacy is challenging. More than 50% of respondents also described feeling generally unwell and irritable.
100% of full respondents had used an exhaustive list of therapies, in addition to a high-fibre diet and adequate fluid intake, and all said the same thing: “They don’t work [for chronic constipation]”. While some treatments might result in a partial bowel movement, they also usually mean suffering through diarrhea and other uncomfortable side effects. When used long-term, many treatments intended for occasional constipation end up increasing the symptoms of chronic constipation. Overuse of laxatives can lead to intestinal inertia, cathartic colon, lazy or laxative gut, irritable bowel syndrome, pancreatitis, and other health problems.
Almost 100% of the patients we surveyed described Resotran™ as a miracle that has given them back their lives. All of the respondents described experiencing normal or close to normal bowel movements with little discomfort after the first few days of treatment. They also found that its effectiveness improved over time. Most of the women also pointed to quality-of-life issues, saying that they were generally happier after taking Resotran™. More than 70% of respondents noted that having to take just one pill a day made Resotran™ an easy treatment to follow. About half of respondents experienced temporary fatigue as a side effect of this medication, but they all indicated that this temporary discomfort was worth it.
When available treatments do not provide effective relief and patients cannot afford innovative prescription medications like Resotran™, they are unable to meet the normal responsibilities in their lives – toward their families, employers, and communities. The GI Society will continue to advocate for patients concerning coverage for medications like Resotran™, with the guiding principal that the right medication should be affordably accessible to the right patient at the right time.
If you are a Canadian woman diagnosed with chronic idiopathic constipation and you have tried Resotran™, please help us support other women like you by filling out the confidential survey on our website, www.badgut.org.