What Is The Definition And Diagnostic Criteria Of Constipation

It is very difficult to define constipation precisely, because it is a subjective matter and there is wide range of normal bowel habits. Constipation for one person may be normal for another. Constipation is persistent, difficult, infrequent, or seemingly incomplete defecation.

Constipation can be acute, simple, and chronic and sever (with fecal impaction).

Acute constipation:

It is of sudden and recent onset, which occurs without any change in routine of bowel habit. Constipation of acute onset needs immediate medical attention, because it may be indicative of serious underlying medical disorder such as cancer, hypothyroidism, neurological problem.

Simple constipation:

Simple constipation is usually short term, which is commonly due to changes in living pattern and dietary changes. Simple constipation may also be due to certain medications or due to stress. Simple constipation usually disappears when the short-term factor(s) causing constipation is removed.

Chronic constipation:

There is long history of constipation, which may be from childhood itself. Chronic constipation usually develops slowly and gradually. Frequency of bowel movement is usually every 3 to 3 days. Cause may be due to poor dietary habits of consuming very little dietary fibers or may be due to physiologic cause.

Sever constipation:

Severe form of constipation, with long history of infrequent bowel movements (may be as less as one bowel movement every 2 to 3 weeks). This may lead to fecal impaction in intestine. Most of the cases there is underlying pathology (such as Hirschsprung’s disease or Megacolon or toxic megacolon) in the gastrointestinal tract.

Diagnostic criteria of constipation:

Rome II criteria for functional constipation:

In the preceding one year (12 months) a person should have at least 2 (or more) of the following symptoms for at least 12 weeks (need not be consecutive weeks),

  • Lumpy or hard stool in at least 25% of bowel movements
  • Straining at defecation for at least 25% of defecation
  • Sensation of seemingly incomplete defecation in at least 25% of defecation
  • Feeling of ano-rectal obstruction at least 25% of defecation
  • Less than 3 bowel movements a week
  • Manual maneuvers (such as digital evacuation, pelvic floor support) to facilitate defecation in at least 25% cases.


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