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Chronic constipation in adults

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Constipation means widely different things to different people and it can be argued that the term 'constipation' per se is unhelpful. Health professionals generally recognise constipation as infrequent episodes of defaecation, whereas patients more readily identify with straining, gas, hard consistency of stool, and abdominal pain.1 There is a wide normal range of defaecatory frequency, ranging from three bowel movements per day to three bowel movements per week in conjunction with a considerable variation in the shades of stool observed.2

Rome consensus
The Rome multinational consensus has sought to establish standardised definitions for the functional gastrointestinal disorders based on symptom and temporal patterns, including chronic constipation (CC).

The Rome consensus, now in its third iteration, defines CC as having two or more of the following features, for the last three months, in one-quarter of defaecations: straining, lumpy or hard stool, the sensation of incomplete evacuation, the sensation of anorectal blockage, manual manoeuvres needed, less than three bowel movements per week, and symptom onset more than six months prior to diagnosis. Such a rigid definition has a limited role in routine clinical practice, but it has improved homogeneity within clinical trials.


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