Critical Constipation.

Area of Science:

• Emergency Medicine
• Gastroenterology
• Clinical Diagnosis

Background:

• Constipation presents frequently in emergency departments (EDs) with diverse gastrointestinal symptoms.
• Effective management requires distinguishing between primary constipation and its dangerous mimics, causes, or complications.

Purpose of the Study:

• To outline the diagnostic and initial management strategies for constipation in the emergency department setting.
• To emphasize the clinical diagnosis of functional constipation and the judicious use of diagnostic studies.

Main Methods:

• Review of clinical guidelines and evidence for constipation management in emergency care.
• Focus on history and physical examination to identify red flags for serious conditions.
• Assessment of the utility of laboratory studies and abdominal imaging.

Main Results:

• Functional constipation is a clinical diagnosis; laboratory studies and imaging are typically unnecessary if red flags are absent.
• Initial disimpaction can be initiated in the ED, but sustained success relies on outpatient management.
• Oral and enema therapies are generally safe but require awareness of contraindications and potential adverse events.

Conclusions:

• Emergency physicians should prioritize clinical assessment for constipation, reserving advanced diagnostics for cases with red flags.
• Initial ED interventions for constipation should be followed by comprehensive outpatient treatment plans.
• Safe administration of oral and enema therapies necessitates understanding their specific contraindications and risks.