Recognizing and Defining Occasional Constipation: Expert Consensus Recommendations

Abstract

Constipation is a common problem, affects 15% of the population, and is often self-diagnosed and self-managed. Over the past 3 decades, there have been significant advances in our understanding and management of chronic constipation, with the emerging recognition that occasional constipation (OC) is another subtype that falls outside current classifications. The purpose of this review was to describe the process of developing and proposing a new definition for OC based on expert consensus and taking into consideration the multifactorial nature of the problem such as alterations in bowel habit that include stool frequency and difficulty with stool passage, perception of the sufferer, duration of symptoms, and potential responsiveness to treatment. Leading gastroenterologists from 5 countries met virtually on multiple occasions through an online digital platform to discuss the problem of OC and recommended a practical, user-friendly definition: "OC can be defined as intermittent or occasional symptomatic alteration(s) in bowel habit. This includes a bothersome reduction in the frequency of bowel movements and/or difficulty with passage of stools but without alarming features. Bowel symptoms may last for a few days or a few weeks, and episodes may require modification of lifestyle, dietary habits and/or use of over-the-counter laxatives or bulking agents to restore a satisfactory bowel habit." Prospective studies are required to validate this definition and determine OC prevalence in the community. This review highlights current knowledge gaps and could provide impetus for future research to facilitate an improved understanding of OC and development of evidence-based management guidelines.

Improving an integrated approach to the treatment of functional constipation in children

“…Зокрема, більшість лікарів загальної практики визначають закреп насамперед як зменшення частоти актів дефекації (наприклад, менше чотирьох на тиждень). Проте пацієнти описують закреп не тільки як зменшення частоти актів дефекації, але й як комплекс симптомів, зі зміною консистенції калових мас (твердий, фрагментований кал тощо), відчуттям неповного випорожнення кишечника, а також необхідністю у надмірному напружуванні для здійснення акту дефекації [9,19].…”

Arctiin alleviates functional constipation by enhancing intestinal motility in mice

“…Dietary and lifestyle changes are current methods for the management of FC in the majority of the population (14). However, patients who experience persistent FC are in need of pharmaceutical-based therapies.…”

The role of community pharmacists in optimising patient self-management of constipation: an inter-disciplinary consensus view

“…Diagnostic and treatment guidelines for constipation are available, but, with few exceptions [1], focus primarily on the management of chronic constipation by physicians [6,9,15]. A definition of occasional constipation has recently been proposed [22], which acknowledges the existence of transient real-life variability in bowel habits in the broad community and the need to restore satisfactory bowel habits, primarily by means of self-management and without physician involvement. Professional organisations and expert panels have provided counselling algorithms for pharmacists [23][24][25], but these typically do not provide practical…”