Diagnosing Constipation Spectrum Disorders in a Primary Care Setting

Abstract

Understanding pathophysiological causes of constipation is worthwhile in directing therapy and improving symptoms. This review aims to identify and fill gaps in the understanding of the pathophysiology of constipation, understand its prevalence, review diagnostic tools available to primary care physicians (PCPs), and highlight patients’ expectations for the management of this common spectrum of disorders. Literature searches conducted via PubMed included terms related to constipation, diagnosis, and patient perceptions. Case studies were developed to highlight the differences between patients who may be appropriately managed in the primary care setting and those requiring specialty consultation. Myriad pathophysiological factors may contribute to constipation, including stool consistency, altered intestinal motility, gut microbiome, anorectal abnormalities, as well as behavioral and psychological factors. Common diagnoses of “primary constipation” include slow-transit constipation, defecation disorders, irritable bowel syndrome with constipation, and chronic idiopathic constipation. A detailed medical history should be conducted to exclude alarm features and PCPs should be familiar with pathophysiological factors that cause constipation, available diagnostic tools, alarm signs, and the various classification criteria for constipation subtypes in order to diagnose and treat patients accordingly. PCPs should understand when a referral to a gastroenterologist, anorectal specialist, pelvic floor physical therapist, and/or mental health specialist is appropriate.

Bifidobacterium longum relieves constipation by regulating the intestinal barrier of mice

“…1 Among them, women have a higher prevalence rate than men (approximately 2.2 : 1). 2 The prevalence is also different among patients of different ages. 3 The incidence in adolescents is about 0.7%-29.6%, while the prevalence among the elderly can reach 30%.…”

Irritable bowel syndrome: classification, dietary approach, pharmacological and psychological treatments

“…IBS M presents a combination of symptoms, where individuals experience alternating episodes of diarrhea and constipation. 16,17 Some people with IBS report the presence of mucus in their stool. While a small amount of mucus is considered normal, an increase in quantity or changes in its appearance may indicate IBS or other gastrointestinal conditions.…”

Exploring Molecular Mechanisms of Aloe barbadmsis Miller on Diphenoxylate-Induced Constipation in Mice

“…Constipation was an intestinal disease performing with clinical functional disorder. e course of constipation was long, and the condition was easy to repeat [1,2]. Recently, with the improvement of the pace of life and the changes of lifestyle, such as sitting for a long time, staying up late, pressure, and many other factors had led to the emergence of constipation.…”