Cited by 338Gastrointestinal motility and disordersPelvic floor disorders treatmentsCongenital gastrointestinal and neural anomalies

Diagnosis and management of chronic constipation in adults

Rao, Satish S. C., Rattanakovit, Kulthep, Patcharatrakul, Tanisa·2016·Nature Reviews Gastroenterology & Hepatology

Abstract

Constipation is a heterogeneous, polysymptomatic, multifactorial disease. Acute or transient constipation can be due to changes in diet, travel or stress, and secondary constipation can result from drug treatment, neurological or metabolic conditions or, rarely, colon cancer. A diagnosis of primary chronic constipation is made after exclusion of secondary causes of constipation and encompasses several overlapping subtypes. Slow-transit constipation is characterized by prolonged colonic transit in the absence of pelvic floor dysfunction. This subtype of constipation can be identified using either the radio-opaque marker test or wireless motility capsule test, and is best treated with laxatives such as polyethylene glycol or newer agents such as linaclotide or lubiprostone. If unsuccessful, subspecialist referral should be considered. Dyssynergic defecation results from impaired coordination of rectoanal and pelvic floor muscles, and causes difficulty with defecation. The condition can be identified using anorectal manometry and balloon expulsion tests and is best managed with biofeedback therapy. Opioid-induced constipation is an emerging entity, and several drugs including naloxegol, methylnaltrexone and lubiprostone are approved for its treatment. In this Review, we provide an overview of the burden and pathophysiology of chronic constipation, as well as a detailed discussion of the available diagnostic tools and treatment options.

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Crossref · 10.1038/nrgastro.2016.53

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  • Many risk factors of functional constipation including age, diet, obesity, and stress have a large impact on the gut microbiota.

    “many risk factors of FC including age, diet, obesity, and stress have a large impact on the gut microbiota [ 33–35 ]”

    From Role of gut microbiota in functional constipation (2021) · cites this paper as [35]

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Authors
Rao, S. S. C., Rattanakovit, K., & Patcharatrakul, T.
Affiliations
Augusta University (US)
Corresponding author
Rao, Satish S. C.
Venue
Nature Reviews Gastroenterology & Hepatology
Published
2016-04-01
Volume
13
Issue
5
Pages
295-305
ISSN
  • 1759-5045 (ISSN-L)
  • 1759-5053
OpenAlex
W2333706939
Cited by
337
References
112
Citations by year
2026: 34 · 2025: 40 · 2024: 45 · 2023: 38 · 2022: 39 · 2021: 38 · 2020: 37 · 2019: 22 · 2018: 18 · 2017: 21 · 2016: 5
FWCI
3.68
Type
journal article
Language
en
Open access
closed
Locations
  • Nature Reviews Gastroenterology & Hepatology (publishedVersion)
  • PubMed (publishedVersion)
Funders
American Neurogastroenterology and Motility Society
Topics
  • Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
  • Health Sciences › Medicine › Rheumatology › Pelvic floor disorders treatments
  • Health Sciences › Medicine › Surgery › Congenital gastrointestinal and neural anomalies
Keywords
chronic constipation, secondary constipation, slow transit constipation, dyssynergic defecation, opioid-induced constipation, anorectal manometry, balloon expulsion test, biofeedback, laxatives, linaclotide, lubiprostone, naloxegol, methylnaltrexone, constipation pathophysiology
MeSH terms
Acute Disease, Adult, Algorithms, Biofeedback, Psychology, Cathartics, Chronic Disease, Colectomy, Constipation, Dietary Fiber, Nonprescription Drugs, Transcutaneous Electric Nerve Stimulation, Gastrointestinal Transit, Humans, Lumbosacral Plexus, Manometry, Medical Records, Risk Factors, Serotonin Agents, Irritable Bowel Syndrome, Digital Rectal Examination, Laxatives

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