[Approach to chronic constipation]

ABSTRACT

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