Consensus statements on diagnosis and management of chronic idiopathic constipation in adults in Hong Kong

Abstract

The estimated prevalence of chronic idiopathic constipation in Hong Kong is 14%. An expert panel of local gastroenterologists has created a set of consensus statements with the aim of providing localised guidance on the diagnosis and management of this common condition by primary care physicians. Participants: An expert panel consisting of seven local gastroenterologists convened in August 2018 in Hong Kong. Evidence: Published primary research articles, metaanalyses, and guidelines and consensus statements issued by different regional and international societies on the diagnosis and management of chronic idiopathic constipation were reviewed. Consensus process: Draft consensus statements were prepared prior to the meeting. The consensus statements were finalised during the meeting with contributions from the panel members based on their collective knowledge and clinical experience. Conclusions: A total of 11 consensus statements were created, including five concerning patient assessment and diagnosis, two relating to nonpharmacological management, and four on Consensus statements on diagnosis and management of chronic idiopathic constipation in adults in Hong Kong

Appearance of food-dependent exercise-induced anaphylaxis as an inflammatory disease: a pediatric case report and differential diagnosis

“…23,24 Another discussed possible mechanism for myocardial injury is the coronary vasospasm secondary to the therapeutic doses of epinephrine for anaphylaxis. 25,26 Our patient only showed an initial increase in myocardial cytolysis markers, which quickly normalized without any clear clinical, electrocardiographic, or echocardiographic signs. Establishing a definite cause of myocardial damage during anaphylaxis is always challenging, and different mechanisms may overlap.…”

Streptococcus gallolyticus endocarditis—an uncommon but serious complication of constipation management

“…To the Editor-I deeply appreciate the timely publication of the Consensus Statement on Chronic Idiopathic Constipation in the current issue of the Hong Kong Medical Journal (April 2019). 1 It addressed many important issues, including advising caution on the popular use of fibre-rich supplements and lactulose. These compounds are indigestible for humans and serve as osmotic bulk expanders to facilitate faecal transit and expulsion.…”

Use of clinical practice guidelines

“…Reviewing CPGs published in the Hong Kong Medical Journal, some have provided guidance on disease screening and prevention, 7,8 whereas others have offered a broad range of clinical topics from management of common clinical complaints to controversial issues based on the most updated evidence. [9][10][11][12][13] Guidelines include concise recommendations and instructions for diagnosis, tests, treatment options, drug therapy, management algorithms that may direct the choice of medical, and surgical or other clinical services. 14 Because CPGs are never perfect and evidence on their effectiveness is incomplete, 14 when making clinical decisions, doctors also consider their experience and knowledge through years of practice and insights gained from the many cases encountered and managed previously.…”