Approach to Chronic Constipation

Abstract

Constipation isa common clinical problem that can be functional or organic in origin. Thiscondition sometimes overlaps with irritable bowel syndrome. Initially, theclinician should differentiate between true and false constipation by clinicaland preclinical evidence such as colonic transit time. Numerous patients believethat all defecation problems are called constipation and use laxatives without aprescription. A vast majority of constipated patients have improvement in theirsymptoms following life style modification and the use of simple laxatives.However onset of recent constipation in patients over the age of fifty shouldbe considered as an organic disease unless proven otherwise. In these patients,colon cancer must be ruled out. Those with irritable bowel syndrome cantransiently face constipation, for which supportive care is sufficient. In thisreview we explain the diagnosis, workup and treatment of constipation.