A Case-Based Approach to Constipation in Primary Care

Primary care physicians frequently evaluate patients with constipation. The history is crucial in uncovering warning symptoms and signs that warrant colonoscopy. Particular elements in the history and rectal examination also can provide clues regarding the underlying etiology. Regardless of etiology...

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Bibliographic Details
Published inThe Medical clinics of North America Vol. 105; no. 1; p. 55
Main Authors Snell, David B, Faruqui, Saamia, Bosworth, Brian P
Format Journal Article
LanguageEnglish
Published United States 01.01.2021
Subjects
Adult
Colonoscopy
Constipation - diagnosis
Constipation - drug therapy
Constipation - etiology
Constipation - physiopathology
Cost of Illness
Dietary Fiber - therapeutic use
Digital Rectal Examination
Female
Humans
Laxatives - therapeutic use
Male
Manometry
Middle Aged
Primary Health Care
Quality of Life
Risk Factors
Laxatives
Defecatory disorder
Constipation
Anorectal manometry
Fiber
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Summary:Primary care physicians frequently evaluate patients with constipation. The history is crucial in uncovering warning symptoms and signs that warrant colonoscopy. Particular elements in the history and rectal examination also can provide clues regarding the underlying etiology. Regardless of etiology, lifestyle modifications, fiber, and laxatives are first-line therapies. Patients who fail first-line therapies can be offered second-line treatments and/or referred for testing of defecatory function. In those with severely refractory symptoms, referrals to a gastroenterologist and a surgeon should be considered.
ISSN:1557-9859
DOI:10.1016/j.mcna.2020.08.015