Diagnosis and Treatment of Constipation

Jeon, Han Ho; Park, Hyojin

Abstract

Constipation is a common condition affecting approximately 16.5% of population in Korea. Evaluation of constipation should be done with a history and physical examination at first. In patients with alarm sign, blood test, radiography or colonoscopy should be considered. Additionally, for defining the pathophysiology and treatment of severe constipation, physiologic studies are needed. Treatment of constipation based on the pathophysiology is generally successful. Exercise and fiber are helpful in some patients with constipation. The laxative including osmotic agent, stimulant laxatives and stool softer have been shown to be more effective than placebo at relieving symptoms of constipation. Traditional laxatives are not tolerated and are not effective in all patients with constipation. Promising drug classes, new enterokinetic agents such as 5-hydroxytyptamine-4 receptor agonists and chloride channel activators could be effective in patients with severe constipation. Biofeedback could relieve symptoms in selected patients with pelvic floor dysfunction and severe constipation. Surgical treatment could be helpful in carefully selected patients with refractory constipation.