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Evaluation of constipation.

Daisy A Arce¹, Carlos A Ermocilla, Hildegardo Costa

¹Department of Family Practice, State University of New York Health Science Center at Brooklyn College of Medicine, 11203, USA. darce@netmail.hscbklyn.edu

American Family Physician

|June 21, 2002

Summary

Constipation causes millions of doctor visits annually. Evaluating a patient

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Area of Science:

Gastroenterology
Primary Care Medicine

Background:

Constipation is a common medical complaint, accounting for 2.5 million physician visits yearly in the U.S.
Discrepancies exist between patient and physician definitions of constipation, complicating diagnosis and treatment.
Primary care physicians manage over half of all constipation-related medical visits.

Purpose of the Study:

To outline an effective approach for diagnosing the underlying causes of constipation.
To differentiate the evaluation and management of constipation in adults versus children.
To emphasize the role of family physicians in managing constipation.

Main Methods:

Comprehensive patient evaluation including general health, psychosocial status, and medical history.
Assessment of dietary fiber intake and use of constipating medications.
Consideration of differential diagnoses specific to adults and children.
Selective use of physiologic function tests for refractory cases.

Main Results:

A thorough evaluation encompassing various patient factors is crucial for identifying constipation's cause.
Distinct diagnostic pathways are necessary for adult and pediatric constipation.
Physiologic testing is typically reserved for cases unresponsive to initial management.

Conclusions:

Family physicians are well-equipped to manage the majority of constipation cases effectively.
A systematic approach ensures accurate diagnosis and appropriate treatment for constipation.
Understanding patient and physician perspectives is key to successful constipation management.

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