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Related Experiment Videos

Clinical management of constipation

J E Lennard-Jones1

  • 1University of London, UK.

Pharmacology
|October 1, 1993
PubMed
Summary

Effective constipation management requires a thorough clinical evaluation to identify underlying causes and guide treatment. Treatment options range from dietary changes and lifestyle adjustments to medicinal bulking agents, tailored to individual patient needs.

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Area of Science:

  • Gastroenterology
  • Clinical Medicine

Background:

  • Constipation is a common condition with diverse symptoms including infrequent defecation, straining, and abdominal discomfort.
  • Identifying the root cause of constipation is crucial for effective treatment.
  • Various underlying abnormalities in the colon, upper gut, or ano-rectum can contribute to constipation.

Purpose of the Study:

  • To outline a systematic approach for evaluating constipation.
  • To detail the diagnostic considerations for identifying causes of constipation.
  • To present a range of available treatment options for constipation.

Main Methods:

  • Clinical evaluation of patient symptoms (infrequent defecation, straining, pain, bloating, malaise, soiling).
  • Assessment for definable abnormalities: megacolon, upper gut neuropathy/myopathy, ano-rectal dysfunction (pelvic floor weakness, prolapse, rectocele, solitary rectal ulcer).
  • Screening for systemic causes (hypothyroidism, hypercalcaemia, neurological/psychiatric disorders) and drug-induced constipation.

Main Results:

  • Treatment choice is guided by comprehensive clinical evaluation.
  • Management strategies include reassurance, dietary fiber increase, toilet training, and altered routines.
  • Medicinal bulking agents (e.g., Ispaghula, methylcellulose) are effective for patients with normal colons struggling to increase dietary fiber intake.

Conclusions:

  • A thorough clinical assessment is paramount for diagnosing and managing constipation effectively.
  • Treatment should be individualized based on identified causes and patient factors.
  • Dietary modifications and bulking agents represent key therapeutic interventions for many constipation cases.

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