Diagnosis of Chronic Constipation

Area of Science:

• Gastroenterology
• Colorectal Surgery

Background:

• Chronic constipation (CC) presents with diverse symptoms, necessitating evaluation for alarm features suggesting malignancy.
• Current guidelines emphasize objective assessment using tools like the Bristol Stool Form Scale and colonoscopy for differential diagnosis.

Purpose of the Study:

• To outline diagnostic strategies for chronic constipation based on the Seoul Consensus.
• To identify the role of physiological testing in managing refractory CC and specific functional constipation subtypes.

Main Methods:

• Review of the Seoul Consensus guidelines on chronic constipation diagnosis and treatment.
• Emphasis on differentiating functional constipation subtypes (normal-transit, slow-transit, defecatory disorder) when initial therapies fail.
• Recommendation of physiological tests such as balloon expulsion test, anorectal manometry, defecography, and colon transit time.

Main Results:

• Initial CC management involves lifestyle changes and first-line therapies.
• Diagnostic testing, including physiological assessments, is crucial for refractory cases or suspected defecatory disorders.
• The Seoul Consensus provides a framework for objective evaluation and subtype differentiation.

Conclusions:

• Accurate diagnosis of CC subtypes is critical for guiding effective treatment strategies.
• Physiological testing plays a key role in managing patients with functional constipation who do not respond to standard treatments.
• The Seoul Consensus offers valuable guidance for healthcare providers in the diagnosis and management of chronic constipation.