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SINGAPORE - A recent survey has found that the majority of Singaporeans do not seek medical help for constipation, largely because they believe it will go away on its own.
The condition affects as many as one in four Singaporeans, but more than 35 per cent of patients wait three months or more before they see a doctor, the survey found.
Surprisingly, the reasons for not seeking medical treatment are neither cost nor embarrassment. The main reason for not seeing a doctor - 60 per cent of respondents - is the mistaken belief that constipation is either not a medical condition or that it will simply go away on its own.
According to Dr Reuben Wong, President of the Irritable Bowel Syndrome Support Group and Consultant, Department of Gastroenterology & Hepatology, National University Hospital, chronic constipation is considered a medical condition.
Constipation is considered chronic when symptoms persist for more than three months.
Common symptoms include straining, lumpy or hard stools, a sensation of incomplete evacuation, anorectal obstruction or blockage, and/or less than three defecations per week.
"Many people believe that they can self treat by eating more fibre or taking a dose of laxatives. But this may not always work," Dr Wong said.
"It is a gut motility disorder that may need prescription treatments such as prokinetics so as to increase motility of the large intestines and bowel movements, should conventional laxatives not work," he added.
The survey of 458 respondents also found that men were more likely than women to seek a doctor's advice.
More than 40 per cent of men said they talked about chronic constipation with a doctor. In contrast, only 22 per cent of women did the same.
Women showed a preference for speaking to their partner or to a friend, while one in five women said they do not speak to anyone at all.
Older patients are more likely to seek medical advice earlier than younger patients, with about 66 per cent of people aged 65 and older seeking medical help within a month.
Talking to the doctor would help as doctors would be able to determine the cause of the chronic constipation and prescribe the appropriate treatments, the researchers said.
In some cases, chronic constipation may also be a symptom of a more serious condition such as colon cancer, and is commonly found in Parkinson's disease or diabetes patients as well.
Patients can find relief from treatment options such as laxatives, which are commonly used to induce bowel movements.
However, almost half of the patients with chronic constipation reported inadequate relief of symptoms from laxatives.
In cases where patients don't respond adequately to fibre and laxatives, prokinetics may be needed to increase the motility of the large intestines and increase bowel movements.
An example of a prokinetic that is available in Singapore is Resolor, which accelerates colonic transit in patients with constipation.
The study was jointly conducted by the Irritable Bowel Syndrome Support Group and Janssen Pharmaceuticals.
yamadak@sph.com.sg