Constipation

Constipation most classically refers to reduced defecation frequency and hard stools. Constipation may be further defined as acute or chronic. The evaluation of constipation begins with understanding the patient's perspective on their altered bowel function and the time course of constipation development. The physical examination is directed to identifying underlying medical causes for constipation, excluding faecal impaction, and providing a preliminary assessment of anorectal function. The initial treatment strategy for constipation nearly always includes the ingestion of more dietary or supplemental fibre. Medication use is strongly correlated with the development of constipation in older people. Randomized controlled trials have established that bio-feedback therapy is effective, and it has become the mainstay treatment for dyssynergic defecation. It involves four to six sessions using visual and verbal feedback techniques to improve symptoms of chronic constipation.