Diagnostic Algorithm for Constipation and Obstructed Defecation
Chronic constipation is a common and disabling problem in many patients all over the world, in particular in elderly. There are two main pathophysiologies, but with possible overlapping situations: disorders of transit and evacuation disorders.
Functional constipation has many causes, including the kind of diet and lifestyle, and it can also be secondary to medications, other many medical conditions, and/or disease. Alarm symptoms sometimes coexist, and it is mandatory to underline these conditions in order to manage the therapeutical approach properly.
Treatment options for chronic constipation include changes in lifestyle, drugs, and rehabilitation of the perineum as well as biofeedback therapies; commonly first-level therapeutical approach is undertaken before the diagnosis of chronic constipation will be cleared, but understanding its etiology is necessary to determine the most appropriate and tailored therapeutic option; history and physical examination of the patients can orientate in an intricate instrumental diagnostic approach which consists of imaging and functional tests.
Our aim is try to clarify on these complicated diagnostic choices in order to optimize therapeutical interventions.
- Bove A, Pucciani F, Bellini M, Battaglia E, Bocchini R, Altomare DF, Dodi G, Sciaudone G, Falletto E, Piloni V, Gambaccini D, Bove V (2012) Consensus statement AIGO/SICCR: diagnosis and treatment of chronic constipation and obstructed defecation (part I: diagnosis). World J Gastroenterol 18:1555–1564CrossRefPubMedPubMedCentralGoogle Scholar
- Gambaccini D, Racale C, Salvadori S, Alduini P, Bassotti G, Battaglia E, Bocchini R, Bove A, Pucciani F, Bellini M; the Italian Constipation Study Group (2013) Chronic constipation: Rome III criteria and what patients think. Are we talking the same language? United European. Gastroenterol J 1 (Supplement 1): 20–21Google Scholar
- Lindberg G, Hamid SS, Malfertheiner P, Thomsen OO, Fernandez LB, Garisch J, Thomson A, Goh KL, Tandon R, Fedail S, Wong BC, Khan AG, Krabshuis JH, LeMair A (2011) World Gastroenterology Organisation global guideline: constipation – a global perspective. J Clin Gastroenterol 45:483–487CrossRefPubMedGoogle Scholar