Chronic constipation: new insights, better outcomes?

Area of Science:

• Gastroenterology
• Internal Medicine

Background:

• Constipation is a prevalent symptom affecting 11-20% of adults annually.
• Patient perception of constipation often centers on straining, differing from the physician's focus on defecation frequency.

Purpose of the Study:

• To highlight the discrepancy between physician and patient definitions of constipation.
• To emphasize the importance of excluding rectal outlet dysfunction in constipation management.
• To guide physicians in assessing and optimizing patient self-treatment strategies.

Main Methods:

• Review of common diagnostic criteria and patient-reported symptoms for constipation.
• Emphasis on physical examination to identify rectal outlet dysfunction.
• Assessment of previous self-management attempts and prescription medication strategies.

Main Results:

• A significant portion of patients experiencing constipation report excessive straining.
• Rectal outlet dysfunction is present in approximately 25% of idiopathic constipation cases.
• Effective management requires a tailored approach beyond simple laxative use.

Conclusions:

• Constipation diagnosis and management should consider both physician and patient perspectives.
• Excluding rectal outlet dysfunction is crucial for appropriate treatment selection.
• Physicians play a key role in optimizing constipation management by assessing prior treatments and strategically using available therapies.