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Consensus statement AIGO/SICCR: diagnosis and treatment of chronic constipation and obstructed defecation (part I: diagnosis).
World J Gastroenterol. 2012 Apr 14; 18(14):1555-64.WJ

Abstract

Chronic constipation is a common and extremely troublesome disorder that significantly reduces the quality of life, and this fact is consistent with the high rate at which health care is sought for this condition. The aim of this project was to develop a consensus for the diagnosis and treatment of chronic constipation and obstructed defecation. The commission presents its results in a "Question-Answer" format, including a set of graded recommendations based on a systematic review of the literature and evidence-based medicine. This section represents the consensus for the diagnosis. The history includes information relating to the onset and duration of symptoms and may reveal secondary causes of constipation. The presence of alarm symptoms and risk factors requires investigation. The physical examination should assess the presence of lesions in the anal and perianal region. The evidence does not support the routine use of blood testing and colonoscopy or barium enema for constipation. Various scoring systems are available to quantify the severity of constipation; the Constipation Severity Instrument for constipation and the obstructed defecation syndrome score for obstructed defecation are the most reliable. The Constipation-Related Quality of Life is an excellent tool for evaluating the patient's quality of life. No single test provides a pathophysiological basis for constipation. Colonic transit and anorectal manometry define the pathophysiologic subtypes. Balloon expulsion is a simple screening test for defecatory disorders, but it does not define the mechanisms. Defecography detects structural abnormalities and assesses functional parameters. Magnetic resonance imaging and/or pelvic floor sonography can further complement defecography by providing information on the movement of the pelvic floor and the organs that it supports. All these investigations are indicated to differentiate between slow transit constipation and obstructed defecation because the treatments differ between these conditions.

Authors

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Pub Type(s)

Consensus Development Conference
Editorial
Research Support, Non-U.S. Gov't
Systematic Review

Language

eng

PubMed ID

22529683

Citation

Bove, Antonio, et al. "Consensus Statement AIGO/SICCR: Diagnosis and Treatment of Chronic Constipation and Obstructed Defecation (part I: Diagnosis)." World Journal of Gastroenterology, vol. 18, no. 14, 2012, pp. 1555-64.
Bove A, Pucciani F, Bellini M, et al. Consensus statement AIGO/SICCR: diagnosis and treatment of chronic constipation and obstructed defecation (part I: diagnosis). World J Gastroenterol. 2012;18(14):1555-64.
Bove, A., Pucciani, F., Bellini, M., Battaglia, E., Bocchini, R., Altomare, D. F., Dodi, G., Sciaudone, G., Falletto, E., Piloni, V., Gambaccini, D., & Bove, V. (2012). Consensus statement AIGO/SICCR: diagnosis and treatment of chronic constipation and obstructed defecation (part I: diagnosis). World Journal of Gastroenterology, 18(14), 1555-64. https://doi.org/10.3748/wjg.v18.i14.1555
Bove A, et al. Consensus Statement AIGO/SICCR: Diagnosis and Treatment of Chronic Constipation and Obstructed Defecation (part I: Diagnosis). World J Gastroenterol. 2012 Apr 14;18(14):1555-64. PubMed PMID: 22529683.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Consensus statement AIGO/SICCR: diagnosis and treatment of chronic constipation and obstructed defecation (part I: diagnosis). AU - Bove,Antonio, AU - Pucciani,Filippo, AU - Bellini,Massimo, AU - Battaglia,Edda, AU - Bocchini,Renato, AU - Altomare,Donato Francesco, AU - Dodi,Giuseppe, AU - Sciaudone,Guido, AU - Falletto,Ezio, AU - Piloni,Vittorio, AU - Gambaccini,Dario, AU - Bove,Vincenzo, PY - 2011/07/31/received PY - 2011/10/21/revised PY - 2012/03/10/accepted PY - 2012/4/25/entrez PY - 2012/4/25/pubmed PY - 2012/10/12/medline KW - Anorectal manometry KW - Balloon expulsion test KW - Colon motility KW - Constipation scoring system KW - Defecography KW - Dyssynergic defecation KW - Obstructed defecation KW - Quality of life KW - Slow transit constipation SP - 1555 EP - 64 JF - World journal of gastroenterology JO - World J. Gastroenterol. VL - 18 IS - 14 N2 - Chronic constipation is a common and extremely troublesome disorder that significantly reduces the quality of life, and this fact is consistent with the high rate at which health care is sought for this condition. The aim of this project was to develop a consensus for the diagnosis and treatment of chronic constipation and obstructed defecation. The commission presents its results in a "Question-Answer" format, including a set of graded recommendations based on a systematic review of the literature and evidence-based medicine. This section represents the consensus for the diagnosis. The history includes information relating to the onset and duration of symptoms and may reveal secondary causes of constipation. The presence of alarm symptoms and risk factors requires investigation. The physical examination should assess the presence of lesions in the anal and perianal region. The evidence does not support the routine use of blood testing and colonoscopy or barium enema for constipation. Various scoring systems are available to quantify the severity of constipation; the Constipation Severity Instrument for constipation and the obstructed defecation syndrome score for obstructed defecation are the most reliable. The Constipation-Related Quality of Life is an excellent tool for evaluating the patient's quality of life. No single test provides a pathophysiological basis for constipation. Colonic transit and anorectal manometry define the pathophysiologic subtypes. Balloon expulsion is a simple screening test for defecatory disorders, but it does not define the mechanisms. Defecography detects structural abnormalities and assesses functional parameters. Magnetic resonance imaging and/or pelvic floor sonography can further complement defecography by providing information on the movement of the pelvic floor and the organs that it supports. All these investigations are indicated to differentiate between slow transit constipation and obstructed defecation because the treatments differ between these conditions. SN - 2219-2840 UR - https://www.unboundmedicine.com/medline/citation/22529683/Consensus_statement_AIGO/SICCR:_diagnosis_and_treatment_of_chronic_constipation_and_obstructed_defecation__part_I:_diagnosis__ L2 - http://www.wjgnet.com/1007-9327/full/v18/i14/1555.htm DB - PRIME DP - Unbound Medicine ER -