Constipation management, with a dietitian's contribution — setting out what I have, and where I think it stops being reliable.
A follow-up question about Constipation management that I did not know to ask the first time.
The earlier thread answered what I asked. What I should have asked is below, and I think it is the one that matters.
Picking up post #3: that is the part I would want checked first.
The number people quote for Constipation management is a central estimate presented without its interval, and the interval is wide enough that the estimate is nearly uninformative on its own.
Coming back to post #3, because the follow-up matters more than the original 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.
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 would be glad to be shown a cleaner way of putting this.
One caution on Constipation management: everything above assumes the underlying documentation is what it claims to be. That assumption is doing real work and is rarely stated.
Grateful for the specificity. Vague answers to this question are what sent me looking.
Post #7 answers the question as asked. The question underneath it is different.
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.
Post #10 and I disagree about the size of the effect, not about the direction.
Constipation management: I have looked for the primary source twice and failed twice. Either it does not exist or it is somewhere I do not know to look, and I would like to know which.
Narrowing post #12, because the general version has more than one answer.
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 have no interest in any supplier named above.
The thing about Constipation management that took me longest to accept is that a plausible mechanism is not evidence of an effect. It is a reason to look, not a result.
Building on post #12 rather than restating it.
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.
That is the version I would defend. It is not the version I started with.
Useful. I have added it to my own notes with the date on it.
I have been on both sides of the Constipation management argument in this category within eighteen months, which should tell you how strong the evidence for either side is.
Post #17 is the version of this I will quote in future. One addition.
Whatever the answer on Constipation management turns out to be, the method for getting there is the same: state the assumption, do the arithmetic in public, invite the correction.
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.
Reporting the observation and leaving the explanation open deliberately.
Constipation: common, manageable, and frequently under-reported because it is not dramatic. Increasing fibre and fluid intake helps. Over-the-counter management is usually effective. This is worth addressing proactively rather than waiting for it to worsen.
I have said this before in a thread nobody could find, so it is worth repeating.
I read post #19 twice before replying, because I had assumed the opposite.
I would rather this thread reach "we do not know" about Constipation management than reach a confident answer that nobody can support when asked.
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.
Posted with less confidence than the sentence structure implies.
What would change my mind on Constipation management is a second dataset collected by someone with no stake in the first. Until then I hold it loosely and I would rather say so than pretend to more.
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 version is the first sentence; the rest is why.
Post #27 describes the usual case. This is about the unusual one.
Adding a null result on Constipation management. I looked, carefully, and found nothing, and null results deserve posting precisely because they never are.
Constipation management would be much easier to settle if anyone reported the denominator. Almost nobody reports the denominator.