Diagnosis and treatment of functional constipation

Assessments of colonic transit and anorectal functions are applied to categorize constipated patients into three groups,including slow transit constipation,outlet obstructive constipation and mixed constipation.The diagnosis of functional constipation is based on the ROME III criteria.Special attention should be paid to secondary constipation resulting from a variety of organic diseases.Management of functional constipation is hindered by both poor efficacy and adverse effects of traditional pharmacological therapy.Further,there is a considerable range of treatment modalities available for patients with functional constipation,but the clinical evidence supporting their use varies widely.Special attention is given to modern approaches to individual therapy including correction of life style and dietary habits as well as the choice of adequate drug therapy.For patients with functional outlet obstructive constipation,biofeedback therapy is the first therapeutic choice.Only patients who have been evaluated by physiologic testing and proven to have severe slow colonic transit constipation may benefit from surgery.Abstract:Summ ary:Assessm ents of colon ic transit and anorectal functions are app lied to categorize constipated pa-tients into three groups,inc lud ing slow transit constipation,outlet obstructive constipation and m ixed constipation.The d iagnosis of functional constipation is based on the ROME III criteria.Spec ial attention shou ld be paid to sec-ondary constipation resu lting from a variety of organ ic d iseases.M anagem ent of functional constipation is h indered by both poor efficacy and adverse effects of trad itional pharm acological therapy.Further,there is a considerab le range of treatm entmodalities availab le for patients w ith functional constipation,but the c lin ical evidence supporting the ir use varies w idely.Spec ial attention is given to modern approaches to ind ividual therapy inc lud ing correction of life style and d ietary hab its as well as the choice of adequate drug therapy.For patients w ith functional outlet ob-structive constipation,b iofeedback therapy is the first therapeutic choice.On ly patients who have been evaluated by physiologic testing and proven to have severe slow colon ic transit constipation m ay benefit from surgery.