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Idiopathic chronic constipation: pathophysiology, diagnosis and treatment
M Candelli1, E C Nista, M A Zocco
1Department of Internal Medicine, Gemelli Hospital, Catholic University, Rome, Italy.
Hepato-Gastroenterology
|August 9, 2001
Summary
Constipation is common, affecting 5-30% of people. This review proposes diagnostic and therapeutic flowcharts for chronic constipation, differentiating idiopathic from secondary causes and specific functional disorders.
Area of Science:
- Gastroenterology
- Digestive Health
Background:
- Constipation is a prevalent condition in Western countries, with a reported prevalence ranging from 5% to 30%.
- Most patients experience mild to moderate symptoms and self-manage with lifestyle changes and over-the-counter laxatives.
- A subset of patients requires further investigation to identify the underlying cause of constipation.
Purpose of the Study:
- To review current global literature on chronic constipation.
- To present a diagnostic and therapeutic flowchart for managing chronic constipation.
- To aid in differentiating between idiopathic and secondary constipation and specific functional subtypes.
Main Methods:
- Literature review of recent world publications on chronic constipation.
- Analysis of diagnostic tools including blood tests, colonoscopy, barium enemas, transit time studies, and manometry.
- Utilizing specific investigations like oro-cecal transit time, manometry, and electromyography for idiopathic subtypes.
Main Results:
- Diagnostic tests can distinguish between secondary and idiopathic constipation.
- Idiopathic chronic constipation encompasses various functional disorders.
- Further investigations identify slow transit constipation and pelvic floor dysfunction as distinct patterns.
Conclusions:
- A structured approach is necessary for effective constipation management.
- Differentiating constipation types allows for targeted therapeutic strategies.
- The proposed flowchart aims to optimize diagnosis and treatment for chronic constipation.