Adult constipation

Constipation is common in adult patients and can be attributed to several possible functional and organic causes. It may have a significant effect on quality of life and may be the presenting feature of significant pathology.

• Diet and lifestyle

• Irritable bowel syndrome

• Drugs

• Neurogenic (central or peripheral)

• Myopathic

• Metabolic

• Pregnancy

• Obstructive lesions

• Anorectal disease

Given an adult patient with constipation, the candidate will diagnose the cause and severity and will initiate an appropriate management plan.

• list and interpret critical clinical findings, including the features of the patient’s history and physical examination that distinguish functional from organic causes;

• list and interpret critical investigations, including investigations required to determine whether the patient needs endoscopic examination or diagnostic imaging; and

• construct an effective initial management plan, including

  • putting in place a conservative plan of symptom management (e.g., dietary and lifestyle changes, appropriate medication use);

  • outlining a plan for managing constipation that is secondary to medications;

  • determining whether the patient requires specialized care; and

  • implementing prevention strategies (e.g., dietary changes, behaviour modification).