Helpful, and easy to find again, which is half of what a good reply is.
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Practice · Side effects · continued
Constipation management, with a dietitian's contribution posts 31–60
This is a continuation of a long topic, addressed by post number rather than by page. Start at post 1 · go to the accepted answer.
The relationship between symptom burden and outcome is not what people assume. Feeling worse is not evidence of a larger effect and feeling nothing is not evidence of an inactive preparation.
A partial answer, offered because a partial answer beats none.
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d.szymanski, post #5: The relationship between symptom burden and outcome is not what people assume. Feeling worse is not evidence of a larger effect and feeling nothing is not evidence of an inactive preparation. Go to post
The bit of constipation management that nobody enjoys is that the answer changes depending on what you are trying to decide with it. Say what the decision is and the thread will converge.
Confirming post #35 from a second method, which matters more than confirming it from a second person.
The published rates come from populations that were titrated on a defined schedule with clinical supervision. Rates from a forum are not comparable and are biased by who chooses to post.
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Where the constipation management discussion usually stalls is that nobody wants to say "I do not know" and everyone is willing to say "it varies". Those are the same sentence with different clothes on.
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sterile_file, post #1: Posting this under the heading it deserves: Constipation management, with a dietitian's contribution Everything below is what sits behind that. Constipation management: setting out the arithmetic in full, because I have had to do it twice and I would rather nobody else did. Every step is shown. If the answer is wrong the error will be… Go to post
The relationship between symptom burden and outcome is not what people assume. Feeling worse is not evidence of a larger effect and feeling nothing is not evidence of an inactive preparation.
It cost nothing to check and would have cost something not to.
Collapsed as off-topic by two members at trust level 3 or above
Constipation management: I would want to see the raw numbers rather than the summary before agreeing. Summaries lose exactly the information that would settle this.
t.nardone, post #33: The relationship between symptom burden and outcome is not what people assume. Feeling worse is not evidence of a larger effect and feeling nothing is not evidence of an inactive preparation. A partial answer, offered because a partial answer beats none. Go to post
The reason constipation management is hard to answer is that the obvious measurement and the relevant quantity are not the same thing, and substituting one for the other is silent.
st.diallo, post #2: The most useful reply I ever got about constipation management was a request to state my units. It sounds like pedantry and it has saved me twice. Go to post
The published rates come from populations that were titrated on a defined schedule with clinical supervision. Rates from a forum are not comparable and are biased by who chooses to post.
The relationship between symptom burden and outcome is not what people assume. Feeling worse is not evidence of a larger effect and feeling nothing is not evidence of an inactive preparation.
On balance I think that is right, and I would not bet much on it.
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dr_okonkwo, post #42: The published rates come from populations that were titrated on a defined schedule with clinical supervision. Rates from a forum are not comparable and are biased by who chooses to post. Go to post
Recognition and grading: nausea ranges from "noticeable" to "limiting". Constipation ranges from mild to severe. Having language to describe the magnitude helps you track whether something is worsening or stable and helps your clinician understand what you are reporting.
sterile_file, post #1: Posting this under the heading it deserves: Constipation management, with a dietitian's contribution Everything below is what sits behind that. Constipation management: setting out the arithmetic in full, because I have had to do it twice and I would rather nobody else did. Every step is shown. If the answer is wrong the error will be… Go to post
Taking post #48 at face value and following it one step further.
The relationship between symptom burden and outcome is not what people assume. Feeling worse is not evidence of a larger effect and feeling nothing is not evidence of an inactive preparation.
Written quickly, so the reasoning may be tighter than the wording.
Adding the boring version of constipation management, because the interesting version keeps getting posted and the boring one is usually right.
Check the ordinary explanations, in order, and stop when one of them accounts for what you are seeing. Most of the time the second one does.
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Where I part company with post #49, and it is a narrow parting.
The published rates come from populations that were titrated on a defined schedule with clinical supervision. Rates from a forum are not comparable and are biased by who chooses to post.
I am reporting what happened, not recommending it.
23 likes 3mo
sterile_file, post #1: Posting this under the heading it deserves: Constipation management, with a dietitian's contribution Everything below is what sits behind that. Constipation management: setting out the arithmetic in full, because I have had to do it twice and I would rather nobody else did. Every step is shown. If the answer is wrong the error will be… Go to post
Post #53 is the version of this I will quote in future. One addition.
The confident answers on constipation management and the well-sourced answers are not the same answers, which is the most useful thing I have learned reading this category.
j.vandermolen, post #31: Helpful, and easy to find again, which is half of what a good reply is. Go to post
Post #53 describes the usual case. This is about the unusual one.
Small correction to my own earlier position on constipation management. I had the units the wrong way round, which changes the conclusion by an order of magnitude and therefore changes it entirely.
The relationship between symptom burden and outcome is not what people assume. Feeling worse is not evidence of a larger effect and feeling nothing is not evidence of an inactive preparation.
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sleep_log, post #52: Before the thread moves on from constipation management — what is the sample size behind the claim? I am not being difficult; I have seen the same figure quoted from an n of four and from an n of four hundred. Go to post
Confirming post #57 from a second method, which matters more than confirming it from a second person.
The published rates come from populations that were titrated on a defined schedule with clinical supervision. Rates from a forum are not comparable and are biased by who chooses to post.
That matches what I was told, which is not the same as knowing it.
sleep_log, post #52: Before the thread moves on from constipation management — what is the sample size behind the claim? I am not being difficult; I have seen the same figure quoted from an n of four and from an n of four hundred. Go to post
On post #57 — agreed on the reasoning, with one qualification.
The relationship between symptom burden and outcome is not what people assume. Feeling worse is not evidence of a larger effect and feeling nothing is not evidence of an inactive preparation.
The short answer was in the first line; everything after is the working.
Thank you for taking the time. That was more work than a reply usually is.
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