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Management of chronic constipation in adults.
K Krogh1, G Chiarioni2, W Whitehead3,4
1Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus, Denmark.
United European Gastroenterology Journal
|June 8, 2017
Summary
Chronic constipation (CC) affects up to 24% of people and is often managed in primary care. Treatment typically starts with lifestyle changes, followed by laxatives, and advanced therapies for refractory cases.
Area of Science:
- Gastroenterology
- Primary Care Medicine
Background:
- Chronic constipation (CC) is highly prevalent, affecting up to 24% of the population.
- CC management is primarily situated within primary care settings.
Purpose of the Study:
- To outline a stepwise management approach for chronic constipation.
- To define indications for advanced diagnostic and therapeutic interventions.
Main Methods:
- Review of current treatment guidelines and clinical evidence for CC.
- Description of a tiered treatment strategy, starting with conservative measures.
Main Results:
- Lifestyle modifications (fiber, fluid, exercise) are first-line treatments.
- Pharmacological interventions (osmotic/stimulant laxatives) are indicated for inadequate response to lifestyle changes.
- Anorectal physiology, transit studies, and imaging are reserved for refractory cases or suspected structural disorders.
Conclusions:
- A systematic approach to chronic constipation management is effective.
- Advanced investigations and treatments are reserved for specific patient subgroups.
- Biofeedback, rectal laxatives, transanal irrigation, and surgery represent later-stage interventions for severe or refractory CC.
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