This article was created by Takeda in coordination with HealthyWomen.

We've all suffered with constipation from time to time, but if you've been living with constipation symptoms that won't go away, you're not alone. Like many others, you may have brought your concerns to your health care provider, and even tried treatments – but if you're still struggling to find relief, don't lose hope!

Chronic idiopathic constipation, or CIC, is a medical condition that affects approximately 46 million Americans and is estimated to impact nearly twice as many women as men. People with CIC have trouble going to the bathroom and experience infrequent or incomplete bowel movements over a long period of time.

To diagnose CIC, a health care professional evaluates the symptoms an individual is experiencing and then determines appropriate next steps based on the specific situation. Yet, according to a national online survey of adults with CIC and gastroenterologists, for many with the condition, relief can be hard to find even after getting a diagnosis and seeking treatment.*

If you are experiencing symptoms of CIC, its important not to give up and to be open with your health care provider about what you're going through, says William Chey, M.D., Professor of Gastroenterology & Nutrition Sciences, and Director of the GI Nutrition and Behavioral Wellness Program at the University of Michigan Health System.

"CIC symptoms can have a significant impact on a person's daily life," said Dr. Chey. "Even after increasing water intake, making lifestyle changes and trying over-the-counter or prescription medications, some people with CIC still struggle to find relief from symptoms, which can leave them feeling that they have no choice but to accept limitations on how they live. That's why it's so important to open up communication about this seldom-discussed condition."

In fact, the national survey, called Current Insights about Constipation, found that the majority of women with CIC generally never feel well and often have to put their lives on pause because of the condition – despite having sought treatment. And, perhaps because bathroom taboos keep this condition in the dark, most feel like no one understands the negative impact CIC has on their everyday lives.

The survey included more than 800 adults with CIC and 250 gastroenterologists. It was conducted by the Harris Poll on behalf of Shire, which is now part of Takeda.

If you've been struggling to find relief from this often-misunderstood condition, below are some things you should know. You can also visit www.TheMuscleWithin.com to read more about CIC and be sure to talk to your doctor. By educating yourself about what may be going on in your body and keeping open and honest communications with your health care provider, you can give yourself the best possible chance to get off pause and get going again.

All statistics below are from the Current Insights about Constipation survey.

1. You're not alone: Feeling like constipation symptoms have taken over your life, yet no one understands? You're not alone. The survey found that even after seeking treatment, 75% of women with CIC generally never feel well and 68% often have to put their lives on pause by avoiding things like traveling, switching jobs, socializing, volunteering and physical fitness because of the condition. 77% feel anxious in public places where bathrooms are limited, and 65% say they are missing out on many of life's moments like family parties and kids' sporting events or recitals because of their CIC. Yet, more than 8 in 10 (84%) feel that no one understands the negative impact CIC has on their everyday lives. Knowing that you're not alone might make you feel more comfortable talking to your health care provider, friends and family about what you are experiencing and seeking support when you need it. Knowing that she's not alone has been a lifeline for Kati, who's been living with CIC since 2015. "Living with this condition can be frustrating and stressful. I've had friends and co-workers who struggle to understand what I'm going through because they'd never heard of CIC before and because I 'don't look sick.' But, seeking out online support from others with CIC and talking openly with my health care providers and immediate family has helped me feel understood, connected and empowered to advocate for myself."
   
   
2. Don't give up: You may be surprised to learn that 44% of women with CIC who have used medication are still trying to find a treatment that works well for them. An overwhelming 87% of women with CIC feel like its symptoms are just something they have to live with, despite having sought treatment. If you're having trouble finding relief from CIC, don't give up. Different CIC treatments work in different ways. Tell your health care provider about what you're going through; only then can you work together to find a treatment approach that's best for you.
   
   *On average, women with CIC who have used medication tried approximately 4 over-the-counter and 2 prescription medications before finding one that worked well for them.
   
   
3. Understand what's happening in your body: Educating yourself about CIC and what's going on in your body may help you feel empowered when speaking to your health care provider. For example, you might find it helpful to know that the colon is actually a muscle – and that it moves involuntarily, similar to how our eyes, heart and lungs move on their own. When functioning properly, the layers of muscle that wrap around the colon squeeze in coordinated wave-like patterns to mix digested food and move it through. While 'idiopathic' by definition means the exact cause is not known, studies have shown that these colon muscle contractions – known as colonic motility, or peristalsis - may not happen often enough in people with CIC. Learn more about what may be happening in your body, and then talk to your health care provider about it. Being informed and talking openly with her health care providers has been extremely important for Kati. "Over time, I've assembled an excellent medical team and learned the best ways to work with them. My gastroenterologist is a motility expert within his field and that changed everything for me. I'm constantly seeking out new information and I always try to be as specific and transparent as possible with my health care providers about what I'm experiencing."
   
   
4. Keep track of your symptoms: As with any condition, your health care provider is your best source of information. And in order to provide them with helpful details, it's important to keep track of your symptoms. Over the next few weeks or months, try keeping a daily record of (1) Diet, fiber and fluids (2) Any treatments used, and whether they're giving you the relief you need (3) Quality and "completeness" of bowel movements (4) Other symptoms (such as bloating, straining). Check out this easy-to-use symptom tracker you can fill out and bring to your next medical appointment to help provide important information about any persistent symptoms you've been experiencing and their frequency.
   
   
5. Get help: If you have CIC and are struggling to find relief, don't wait to seek help."It's important to keep open lines of communication with your health care provider about any ongoing symptoms you're experiencing, as well as how they're impacting your life" said Dr. Chey. "Keep in mind that your health care provider wants to help address your specific needs, and he or she needs to hear from you about what's going on in order to do so."

Visit www.TheMuscleWithin.com to learn more, and then talk to your health care provider.

Dr. Chey received monetary compensation from Takeda to help create this HealthyWomen resource.

HealthyWomen conducted an independent medical review. This resource was medically reviewed by Kathryn Jack, MSN, APRN, FNP-BC, FAANP.

*About the Current Insights about Constipation Survey
The Current Insights about Constipation Survey was conducted online within the U.S. by The Harris Poll on behalf of Shire between April 16 and June 6, 2018. Shire is now a part of Takeda. The patient arm of the survey included a total of 881 U.S. adults aged 18+ (N=274 male and N=607 female) who have been diagnosed by a health care professional with CIC and who sought treatment for the condition ("people with CIC" or "CIC patients"). The professional arm of the survey included 250 GIs licensed to practice in the U.S. who have seen 15 or more CIC patients in the past month. For complete research method, including weighting variables and subgroup sample sizes, please contact Amy McCarthy, GI Lead, US Business Unit Communications, Takeda, at amy.mccarthy@takeda.com.

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