Resumo
Definição
História e exame físico
Principais fatores diagnósticos
- presence of risk factors
- infrequent stools
- difficult defecation
- sensation of incomplete evacuation
- excessive straining
Outros fatores diagnósticos
- hard stools
- abdominal mass
- signs suggestive of underlying medical disorder
- anorectal lesions
- abnormality on digital rectal examination (DRE)
Fatores de risco
- female sex
- age >65 years
- African ancestry
- lower socioeconomic status
- family history
- sedentary lifestyle
- low fibre intake
- inadequate calorie intake
- inadequate fluid intake
- surgical procedures and childbirth
- use of drugs that induce constipation
Investigações diagnósticas
Primeiras investigações a serem solicitadas
- full blood count (FBC)
- thyroid function tests
- serum electrolytes, calcium, and magnesium
- blood glucose
- quantitative faecal immunochemical test
- abdominal x-ray
- barium enema
Investigações a serem consideradas
- barium defecography
- magnetic resonance defecography
- colonoscopy
- colonic transit study
- anorectal manometry
- balloon expulsion studies
- colonic manometry
Algoritmo de tratamento
opioid-induced
not opioid-induced: symptoms <3 months
not opioid-induced: symptoms ≥3 months
suspicion for dyssynergia or refractory to pharmacotherapy
Colaboradores
Autores
Satish Rao, MD, PhD, FRCP (Lon), FACG, AGAF
Professor of Medicine
Chief, Section of Gastroenterology and Hepatology
Director, Digestive Health Center and Neurogastroenterology and GI Motility
Medical College of Georgia
Georgia Regents University
Augusta
GA
Declarações
SR serves on the advisory board for Vibrant Limited, Sanofi Pharmaceuticals, Viatris Pharmaceuticals, Laborie Medical Technologies, Atmo Biosciences, Ardelyx, Neurogut, Biora Therapeutics, Valeant Pharmaceuticals, Neurogut, Inc., and Takeda Pharmaceuticals. SR is an author of a number of references cited in this topic.
Dariush Shahsavari, MD
Senior Gastroenterology Fellow
Internal Medicine, Division of Gastroenterology/Hepatology
Augusta University
Augusta
GA
Declarações
DS declares that he has no competing interests.
Agradecimentos
Dr Satish Rao and Dr Dariush Shahsavari would like to gratefully acknowledge Dr Amol Sharma, Dr Humberto Sifuentes, and Dr Ashok Attaluri, previous contributors to this topic.
Declarações
AS declares that he is on the advisory board for Ironwood Pharmaceuticals. HS declares that he has no competing interests. AA is an author of one reference cited in this topic.
Revisores
Stefan Muller-Lissner, MD
Professor
Abteilung fur Innere Medizin
Park-Klinik Weissensee
Berlin
Germany
Declarações
SML declares that he has no competing interests.
Eamonn M.M. Quigley, MD, FRCP, FACP, FACG, FRCPI
Professor of Medicine and Human Physiology
Department of Medicine
Clinical Sciences Building
Cork University Hospital
Cork
Ireland
გაფრთხილება:
EMMQ has served as a consultant or on advisory boards for the following companies: Sucampo, Movetis, Norgine, Procter and Gamble, Boehringer Ingelheim, Reckitts Benckiser, Schering, Novartis, Salix, Ironwood, and McNeill Consumer Health and has been paid for his time involved. EMMQ is an author of several references cited in this topic.
Ned Snyder, MD
Chief of Gastroenterology and Hepatology
Kelsey-Seybold Clinic
Adjunct Professor of Medicine
University of Texas Medical Branch
Houston
TX
გაფრთხილება:
Not disclosed.
დიფერენციული დიაგნოზები
- Anal fissure
- Hypercalcaemia
- Hypothyroidism
მეტი დიფერენციული დიაგნოზებიგაიდლაინები
- Suspected cancer: recognition and referral
- Pharmacological Management of Chronic Idiopathic Constipation
მეტი გაიდლაინებიპაციენტის ბროშურები
Constipation in adults
მეტი პაციენტის ბროშურები
შედით სისტემაში ან გამოიწერეთ BMJ Best Practice
ამ მასალის გამოყენება ექვემდებარება ჩვენს განცხადებას