Date: {{$ActivityAssignDate}}

Dear Dr. {{ $doctorName }},

Subject: Participation in survey for "Constipation management - understanding HCP perspective & Insights from Clinical Practice in India"

Constipation seems like a ubiquitous condition, something people of all ages experience and many complain about. It is often associated with infrequent bowel movements; however, in reality, constipation has a wide array of symptoms including hard stools, feeling of incomplete evacuation, abdominal discomfort, bloating, distension, excessive straining, sensation of anorectal blockage, or need for manual maneuvers during defecation. Constipation is categorized into 3 subgroups based on the assessment of colonic transit and anorectal function. Determining the type of constipation is very important as it ensures how it should be further evaluated and treated.

Chronic constipation (CC) is a prevalent issue in medical practice globally with the prevalence estimates for the condition ranging from 2% to 24% in the Western world. In spite of the scarcity of data, available studies indicate CC to be a common health problem in India. The precise prevalence of constipation is unknown, but approximately 2% of the population experiences persistent and recurring constipation, with a higher prevalence in women than in men. Self-reported constipation rates range from 24% to 37% in the general population. Among institutionalized elderly individuals, up to 50% report constipation, and up to 74% use laxatives regularly. The National health portal of India (NHP) reports that self-reported constipation is prevalent in 24% to 37% of the population, and CC affects 22% of adult Indians, with 13% experiencing severe constipation and 6% suffering from CC with comorbidities. In a community-based survey conducted in India, it was reported that the prevalence of self-reported constipation within the past year was 24.8%.

In spite of the scarcity of data, available studies indicate CC to be a common health problem in India, contradicting the popular belief of its infrequency due to vegetarianism with high fiber intake, and higher frequency of bowel movement, suggesting that CC might be, in fact, under-reported. The female population is expected to suffer from CC more frequently than male due to slower transit, pelvic floor dysfunction due to obstetric trauma, harder stool forms, and over reporting. Female population had a greater reduction of stool frequency with increasing age compared to males. The frequency of CC increases with age. In the coastal eastern Indian study, stool frequency reduced with age, particularly among female.

This survey is designed to understand Constipation management, HCP perspective & Insights from Clinical Practice in India.

If you agree to participate, you will be required to respond to questions of the enclosed questionnaire. We trust you and we are partners in promoting safe and effective drug therapy. In that spirit we hope you will consent to participate in this survey. If you do, please sign and return the enclosed reply along with your visiting card for accuracy of records.