Chronic constipation

• Chronic constipation is a prevalent condition that severely impacts the quality of life of those affected. Several types of primary chronic constipation, which show substantial overlap, have been described, including normal-transit constipation, rectal evacuation disorders and slow-transit constipation. Diagnosis of primary chronic constipation involves a multistep process initiated by the exclusion of 'alarm' features (for example, unintentional weight loss or rectal bleeding) that might indicate organic diseases (such as polyps or tumours) and a therapeutic trial with first-line treatments such as dietary changes, lifestyle modifications and over-the-counter laxatives. If symptoms do not improve, investigations to diagnose rectal evacuation disorders and slow-transit constipation are performed, such as digital rectal examination, anorectal structure and function testing (including the balloon expulsion test, anorectal manometry or defecography) or colonic transit tests (such as the radiopaque marker test, wireless motility capsule test, scintigraphy or colonic manometry). The mainstays of treatment are diet and lifestyle interventions, pharmacological therapy and, rarely, surgery. This Primer provides an introduction to the epidemiology, pathophysiological mechanisms, diagnosis, management and quality of life associated with the commonly encountered clinical problem of chronic constipation in adults unrelated to opioid abuse.

Subject headings

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine (hsv//eng)

Keyword

chloride

laxative

prokinetic agent

serotonin agonist

sodium

sodium chloride

age

anorectal pressure

chronic constipation

clinical outcome

colon

comorbidity

defecography

digital rectal examination

fluid intake

fluid transport

gastrointestinal tract scintiscanning

geography

high fiber diet

human

intestinal secretion

intestine absorption

intestine innervation

intestine motility

ion transport

lifestyle modification

pathophysiology

patient selection

pharmaceutical care

physical activity

prevalence

priority journal

prophylaxis

quality of life

regulatory mechanism

Review

scintigraphy

screening

sex

social status

Publication and Content Type

ref (subject category)

art (subject category)