Constipation: Difference between revisions
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== Etiology == | == Etiology == | ||
The prevalence of chronic constipation in North America 2% to 27%, the percentage varies because of the differing diagnostic criteria used.<ref>Suares NC, Ford AC. Prevalence of, and risk factors for, chronic idiopathic constipation in the community: systematic review and meta-analysis. The American journal of gastroenterology. 2011 Sep;106(9):1582.</ref> | The prevalence of chronic constipation in North America 2% to 27%, the percentage varies because of the differing diagnostic criteria used.<ref>Suares NC, Ford AC. Prevalence of, and risk factors for, chronic idiopathic constipation in the community: systematic review and meta-analysis. The American journal of gastroenterology. 2011 Sep;106(9):1582.</ref> | ||
Secondary causes of constipation include: | |||
Neurologic | |||
Metabolic disorders | |||
Obstructive lesions of the gastrointestinal tract, such as colorectal cancer | |||
Endocrine disorders, such as diabetes mellitus | |||
Psychiatric disorders such as anorexia nervosa | |||
Aganglionosis (Hirschsprung disease) | |||
Irritable Bowel Syndrome | |||
Functional Outlet Disorder (known as dyssynergic defecation or pelvic floor dyssynergia) | |||
Side-effects of drugs | |||
== Clinically Relevant Anatomy == | == Clinically Relevant Anatomy == | ||
Revision as of 19:01, 19 March 2019
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Definition[edit | edit source]
Chronic constipation is infrequent bowel movements or difficult passage of stools that persists for several weeks or longer.[1]
Etiology[edit | edit source]
The prevalence of chronic constipation in North America 2% to 27%, the percentage varies because of the differing diagnostic criteria used.[2]
Secondary causes of constipation include:
Neurologic
Metabolic disorders
Obstructive lesions of the gastrointestinal tract, such as colorectal cancer
Endocrine disorders, such as diabetes mellitus
Psychiatric disorders such as anorexia nervosa
Aganglionosis (Hirschsprung disease)
Irritable Bowel Syndrome
Functional Outlet Disorder (known as dyssynergic defecation or pelvic floor dyssynergia)
Side-effects of drugs
Clinically Relevant Anatomy[edit | edit source]
Please see the page "Pelvic Floor Anatomy," for further details regarding anatomy.
Clinical Presentation[edit | edit source]
An international working committee recommended the following diagnostic criteria (Rome IV) for functional constipation:[3]
- Must include two or more of the following:
- Straining during more than 25 percent of defecations.
- Lumpy or hard stools (Bristol Stool Scale Form 1-2) in more than 25 percent of defecations (figure 1).
- Sensation of incomplete evacuation for more than 25 percent of defecations.
- Sensation of anorectal obstruction/blockage for more than 25 percent of defecations.
- Manual maneuvers to facilitate more than 25 percent of defecations (eg, digital evacuation, support of the pelvic floor).
- Fewer than three spontaneous bowel movements per week.
2. Loose stools are rarely present without the use of laxatives
3. There are insufficient criteria for IBS. (See "Clinical manifestations and diagnosis of irritable bowel syndrome in adults".)
Although patients with functional constipation may have abdominal pain and/or bloating, they are not the predominant symptoms.
Management/Interventions[edit | edit source]
Education
Diet
Physiotherapist
Biofeedback can be a very useful tool for patients
Physician
References[edit | edit source]
- ↑ Mayo Clinic. Constipation. Available from: https://www.mayoclinic.org/diseases-conditions/constipation/symptoms-causes/syc-20354253
- ↑ Suares NC, Ford AC. Prevalence of, and risk factors for, chronic idiopathic constipation in the community: systematic review and meta-analysis. The American journal of gastroenterology. 2011 Sep;106(9):1582.
- ↑ Longstreth GF, Thompson WG, Chey WD, Houghton LA, Mearin F, Spiller RC. Functional bowel disorders. Gastroenterology. 2006 Apr 1;130(5):1480-91.
