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Constipation

Daniel R. Matta, DFPHM, FAAFP, MD and Jeremy Maxwell, MBBS Reviewed 04/2024
 


BASICS

  • Unsatisfactory defecation characterized by infrequent stools, difficult stool passage, or both.

  • Characteristics include <3 bowel movements a week, hard stools, excessive straining, prolonged ...

DIAGNOSIS

ALERT

Red flags:

  • New onset after age of 50 years

  • Fever

  • Nausea/vomiting

  • Hematochezia/melena

  • Unintentional weight loss > 10 pounds (4.5 kg)

  • Change in bowel habits/Narrowing of the stool

  • Family hist...

TREATMENT

GENERAL MEASURES

In patients with no known secondary causes, conservative nonpharmacologic treatment is recommended. 
  • Eliminate medications that cause constipation.

  • Increase fluid intake.

  • Increa...

ONGOING CARE

DIET

Increase soluble fiber (bloating and gas can be problematic with insoluble fiber): 
  • Gradually increase intake to 25 g/day over a 6-week period.

  • Oat bran, peas, onions, lentils, beans, s...

REFERENCES

1
Sadler K, Arnold F, Dean S. Chronic Constipation in Adults. Am Fam Physician. 2022;106(3): 299-306.
2
Bharucha AE, Lacy BE. Mechanisms, Evaluation, and Management of Chronic Constipation. Ga...

CODES

ICD10

  • K59.00 Constipation, unspecified

  • K59.01 Slow transit constipation

  • K59.09 Other constipation

  • K59.02 Outlet dysfunction constipation

SNOMED

  • 14760008 Constipation (disorder)

  • 35298007 Slow transit co...

CLINICAL PEARLS

  • Consider new-onset constipation after age 50 years a “red flag” for colorectal neoplasms

  • Consider Hirschsprung disease in cases of newborn/infant constipation

  • In patients with no known s...

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