JAMA : the journal of the American Medical Association
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Chronic constipation accounts for at least 8 million annual visits to health care providers in the United States and is associated with large expenditures for diagnostic testing and prescription and nonprescription laxatives. ⋯ The choice of treatment for CIC and OIC should be based on cost as well as efficacy. The small subgroup of patients who do not respond to currently available laxatives requires further evaluation at experienced centers that are capable of performing studies of defecation and colonic transit.