Diagnosis and treatment of constipation: a review

ABSTRACT

Constipation is a common medical problem that imposes multiple clinical referrals in addition to familial and social impacts. The condition is functional in most cases, despite the presence of several etiologies, especially in severe cases and patients unresponsiveness to treatment. Assessment of secondary causes are important. A comprehensive and economic diagnostic and treatment approach for the large number of cases suffering from this medical problem is essential. In medical history and physical examination, the patient's aim regarding the word "constipation" should be considered, and symptoms and signs of secondary causes [such as weight loss, gastrointestinal bleeding, anemia, and ...] should be evaluated. In cases without these alarming clues, treatment with fibers, diet, liquids, physical activity and discontinuation of medications resulting in constipation can be recommended. Re-evaluation of patients in order to find out other defecation problems, slow transit of colon, and secondary causes like malignant or metabolic etiologies should be considered. Defecation problems resisting medical treatment, are always responding to biofeedback treatment. Psychological support and consultation are also helpful in treatment. Long term consumption of medications affecting constipation should be considered with due regard to their side effects. Surgical operations might be performed in unresponsive patients. It should be mentioned that success of surgical methods are greatly dependent on concise selection of patients; lowest success are detected in cases with background psychological problems. Researches on new treatment options for constipation are continually conducted