Bali Chronic Constipation Roundtable Report: Chronic Constipation Management in Asia.

Area of Science:

• Gastroenterology
• Public Health
• Clinical Practice

Background:

• Chronic constipation is a prevalent yet underdiagnosed condition across Asia, significantly impacting quality of life and healthcare systems.
• Cultural stigma, diverse dietary habits, and limited access to standardized diagnostic tools contribute to delayed diagnosis and treatment.

Purpose of the Study:

• To address the challenges in diagnosing and managing chronic constipation in Asia.
• To identify key barriers to care and propose region-specific recommendations for improving patient outcomes.

Main Methods:

• Convened the Bali Chronic Constipation Roundtable in November 2024, involving experts from 11 Asian countries.
• Reviewed epidemiological data and analyzed multinational clinical practice patterns through questionnaires.
• Conducted structured discussions to identify barriers and formulate recommendations.

Main Results:

• Prevalence of chronic constipation varies widely across Asia (1.8% in India to 16.6% in Japan), disproportionately affecting women and the elderly.
• Under-reporting is linked to cultural taboos and self-treatment; Rome IV criteria may not fully capture Asian symptom profiles.
• Access to advanced diagnostics (motility labs) and newer therapies (pharmacotherapies, biofeedback) is limited and unevenly distributed.

Conclusions:

• Asia requires region-specific diagnostic and management strategies for chronic constipation.
• Addressing gaps in diagnosis and treatment, alongside enhanced collaboration, is crucial for standardizing care and advancing research.