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Chronic Constipation in Adults: The Primary Care Approach

Lookup NU author(s): Emeritus Professor Amritpal Hungin


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© 2021 S. Karger AG, Basel.BACKGROUND: Primary care is normally the initial point of presentation and management of patients with chronic constipation (CC). CC has a prevalence of 3-27%, predominantly amongst females and in the older population, and is associated with a reduced quality of life. Effective management can be a challenge without a structured approach. SUMMARY: Whilst conventional teaching defines constipation as the number of stools per week, patients complain mainly of other symptoms such as straining and stool consistency rather than frequency. Symptoms need to be correlated with the likely causes, and ruling out secondary causes and treatment should be symptom driven, distinguishing between functional constipation and irritable bowel syndrome with CC. Treatment can be stepwise or involve combinations of therapies. There is a poor evidence base for most common managements, including lifestyle measures, although stimulant laxatives can be effective. Key Messages: Failure of routine treatment and an early consideration of alternative causes should lead to collaboration with a specialist, especially as many problems, such as pelvic floor disorders, gynaecological problems, and dyssynergic defecation, require secondary care investigations and remedies. In light of our ageing population, CC should be considered thoughtfully and the diagnosis and management tailored to the individual, to maintain good quality of life.

Publication metadata

Author(s): Hungin AP

Publication type: Review

Publication status: Published

Journal: Digestive diseases

Year: 2022

Volume: 40

Issue: 2

Pages: 142-146

Print publication date: 01/02/2022

Online publication date: 18/04/2021

Acceptance date: 13/04/2021

ISSN (print): 0257-2753

ISSN (electronic): 1421-9875

Publisher: NLM (Medline)


DOI: 10.1159/000516489

PubMed id: 33866320