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Overview of Constipation

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Constipation

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Abstract

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.

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Authors and Affiliations

  1. Division of Gastroenterology and Hepatology, University of Connecticut Health Center, 263 Farmington Avenue, Farmington, CT, 06030-1845, USA

    Renée M. Marchioni Beery D.O. & Reena V. Chokshi M.D.

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  1. Renée M. Marchioni Beery D.O.
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  2. Reena V. Chokshi M.D.
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Correspondence to Reena V. Chokshi M.D. .

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  1. School of Medicine, University of Connecticut, Farmington, Connecticut, USA

    Suzanne Rose, MD, MSEd

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Beery, R.M.M., Chokshi, R.V. (2014). Overview of Constipation. In: Rose, MD, MSEd, S. (eds) Constipation. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-0332-0_1

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