From the Guidelines
Constipation is defined as the slow movement of faeces through the large intestine, resulting in infrequent bowel movements and the passage of dry, hard stools. According to the Rome III criteria, chronic constipation is characterized by the presence of any two of the following symptoms for at least 12 weeks in the previous 12 months: straining during bowel movements, lumpy or hard stool, sensation of incomplete evacuation, sensation of anorectal blockage or obstruction, manual evacuation procedures to remove stool, and less than 3 bowel movements per week 1. The experience of constipation is highly subjective and should take into account measurable objective symptoms, including individual stool characteristics and frequency of defaecation, as well as patient perception, level of discomfort, and ease of defaecation 1.
Key Characteristics of Constipation
- Infrequent bowel movements (less than 3 per week)
- Hard, dry, and difficult-to-pass stools
- Straining during bowel movements
- Sensation of incomplete evacuation
- Sensation of anorectal blockage or obstruction
- Manual evacuation procedures to remove stool It is essential to note that constipation can be caused by various factors, including inadequate fiber or fluid intake, physical inactivity, certain medications, and medical conditions, and can significantly impact quality of life 1.
From the Research
Definition of Constipation
- Constipation is defined as having fewer than 3 bowel movements per week and/or more than one fourth of bowel movements with Bristol stool form types 1 or 2 2
- It can also be generally defined as less than three bowel movements per week 3
- The condition affects people regardless of race, age, or sex, although it is most common in women and in the elderly 2
Key Characteristics
- Stool size, frequency, and straining and discomfort on defecation are important factors to consider in the evaluation of constipation 3
- The influence of age, gender, and society should also be taken into account 3
- Constipation can be classified into different etiologies, including dietary, drug induced, metabolic, neurologic, and anatomic 3
Diagnosis and Treatment
- A symptom-based diagnosis is recommended in the absence of alarm features 2
- Treatment options include lifestyle and general measures, bulking agents, osmotic laxatives, stimulant laxatives, prokinetic agents, and intestinal secretagogues 2
- Biofeedback may be indicated in patients with functional defecation disorders 2
- Increasing dietary fiber intake is a common recommendation for managing constipation, with soluble fibers such as psyllium showing better results than insoluble fibers 4