Comparison analysis between domestic and foreign guidelines on constipation diagnosis and treatment

Abstract

We compared and analyzed the guidelines at home and abroad on constipation diagnosis and treatment, and elucidated its concept, incidence and classification, as well as its etiology classification, diagnosis and treatment methods. Currently, constipation is considered as a disease with higher incidence, especially in the elderly and the patients with multiple comorbidities. Constipations are concisely classified as colonic slow transit constipation, outlet obstruction constipation and functional defecation disorders. According to its etiology, constipations are divided into 3 categories: functional disease, organic disease and drug-induced disease. Comprehensive examinations of constipation are helpful to understand its etiology and classification and to guide accurate treatment. Colonoscopy is valuable in the detection of polyp and organic disease of colonic rectum in constipation patients. Nonsurgical treatments are very important for constipation, including health education, dietary regulation, establishment of bowel habits, and graded use of drug. The surgical methods for slow transit constipation include subtotal colectomy with cecoproctostomy, total colectomy with ileoproctostomy, colonic exclusion and ileostomy. Laparoscopic ventral mesh rectal suspension is commonly performed abroad to treat internal rectal prolapse of outlet obstruction constipation. Transvaginal and transanal approaches are used for the surgical treatment of rectocele. In the treatment of constipation, health education and non-surgical treatments should be emphasized. Surgical treatment must be considered only after the systematic non-surgical treatments are ineffective or not effective.

Keywords

• constipation
• guidelines
• classification
• etiology
• diagnosis
• treatment