Overview of Constipation

  • Renée M. Marchioni Beery
  • Reena V. ChokshiEmail author


Constipation is one of the most frequently encountered digestive complaints in both primary care and gastroenterology subspecialty settings. A symptomatically defined disorder, constipation is commonly characterized by infrequent and/or difficult evacuation of stool. Conventionally, constipation was defined as having fewer than or equal to three bowel movements per week; however, it is now understood that reports of stool frequency alone are inconsistent and that number of stools does not necessarily correlate with complaints or pathology. Constipated patients may experience a variety of other symptoms, including straining during defecation, passage of hard or lumpy stools, feelings of incomplete rectal evacuation, prolonged stooling time, and need for manual maneuvers to pass stool. Thus, constipation is now commonly defined by the Rome criteria, an evidence-based consensus opinion that embraces the inherent heterogeneity of this condition. Prevalence estimates of constipation are high with a median range of 12–19 % in the United States alone. The economic burden and health-care costs associated with diagnosing and treating constipation are significant, and patients experiencing the condition report diminished quality of life. Various factors can lead to constipation including systemic processes and medications. Once these factors are ruled out, patients can be diagnosed with primary constipation. This clinical classification can be further divided into normal- or slow-transit constipation, pelvic floor disorders, or constipation-predominant irritable bowel syndrome (IBS-C). Significant overlap exists among these subcategories. Therefore, a thorough history and physical examination are essential in guiding diagnostic testing and tailoring management strategies.


Irritable Bowel Syndrome Pelvic Floor Rectal Prolapse Pelvic Floor Dysfunction Pelvic Floor Disorder 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Renée M. Marchioni Beery
    • 1
  • Reena V. Chokshi
    • 1
    Email author
  1. 1.Division of Gastroenterology and HepatologyUniversity of Connecticut Health CenterFarmingtonUSA

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