Diagnostic approach to chronic constipation in adults.

Area of Science:

• Gastroenterology
• Geriatrics

Background:

• Constipation is commonly defined as fewer than three bowel movements weekly.
• Risk factors encompass female sex, advanced age, inactivity, poor nutrition, and polypharmacy.
• Chronic constipation is categorized as functional (primary) or secondary, with functional types including normal transit, slow transit, or outlet constipation.

Purpose of the Study:

• To review the definition, risk factors, and classification of constipation.
• To highlight the unique presentation of constipation in frail older adults.
• To outline the diagnostic approach, emphasizing the identification of alarm symptoms.

Main Methods:

• Literature review of constipation definition, risk factors, and classifications.
• Discussion of secondary causes, including medications and medical conditions like hypothyroidism and irritable bowel syndrome.
• Emphasis on clinical evaluation, including history, physical examination, and recognition of alarm signs.

Main Results:

• Constipation has numerous risk factors and classifications.
• Frail older patients may exhibit atypical symptoms such as delirium and anorexia.
• Alarm signs necessitating prompt evaluation include bleeding, weight loss, anemia, acute onset in the elderly, and rectal prolapse.

Conclusions:

• A thorough evaluation is crucial for diagnosing constipation.
• Identifying alarm symptoms is paramount for timely intervention and preventing complications.
• Referral to subspecialists may be required for complex cases.