Introduction: Chronic constipation is a common disorder with a reported prevalence ranging from 3% to 27% in the general population. Several management strategies, including diagnostic tests, empiric treatments, and specific treatments, have been developed. Our aim was to develop European guidelines for the clinical management of constipation.Design: After a thorough review of the literature by experts in relevant fields, including gastroenterologists, surgeons, general practitioners, radiologists, and experts in gastrointestinal motility testing from various European countries, a Delphi consensus process was used to produce statements and practical algorithms for the management of chronic constipation. 2 of 33 | SERRA Et Al.
| INTRODUC TI ONChronic constipation is a common disorder with a reported prevalence ranging from 3% to 27% in the general population. 1,2 Its prevalence increases with age 3,4 and consequently is expected to rise over the next few years, 5 in parallel with the predicted increase in longevity of the European population. Constipation is a symptom that may have diverse etiologies, and for this reason, several diagnostic approaches and treatment options are available, ranging from simple lifestyle changes and general measures to sophisticated pharmacological treatments and surgical interventions. 6 In an attempt to unify the health care received by the population across Europe, the European Society of Neurogastroenterology and Motility (ESNM) decided to develop European guidelines to help physicians to take the best decisions to improve the quality of health in patients suffering from common functional and motor disorders. In this document, we present the ESNM guidelines for chronic constipation, which are intended to be a useful tool for the management of this condition in the general population in Europe. In order to produce comprehensive guidelines addressing the different aspects related with constipation, experts from European countries working in related fields developed relevant statements after a thorough review of the available literature, and final recommendations and management algorithms were produced following a Delphi consensus process.
| ME THODS
| ParticipantsA chair (Jordi Serra) and co-chair (Daniel Pohl) were commissioned by the ESNM Steering Committee to develop the guidelines. A panel of 12 experts from different European countries, constituted by gastroenterologists, surgeons, general practitioners, radiologists, and experts in gastrointestinal (GI) motility testing, was invited by the chairs to participate in the development of the guidelines. Each expert was assigned to develop a specific area of the document (see below) and to establish a team with one or two co-workers to complete the assigned task. The final ESNM guidelines working group was composed of 13 experts and 9 co-authors.
| The Delphi consensusEach expert and co-worker conducted a thorough review of the literature in their specific field of expertise. The following areas were covered by the different subgrou...
