Constipation: Definition and Types

by Kelley Chuang, MD

My Notes
  • Required.
Save Cancel
    Learning Material 2
    • PDF
      Slides Gastroenterology 03 Constipation.pdf
    • PDF
      Download Lecture Overview
    Report mistake

    00:00 Welcome, today we'll discuss the approach to the patient with constipation.

    00:06 So first let's define what is constipation? Clinically speaking, it is defined by having at least 2 of the following symptoms: Straining with defecation, the passage of lumpy or hard stools, a sensation of incomplete defecation, having to use manual maneuvers to facilitate the bowel movement, and having a frequency of less than 3 bowel movements a week.

    00:31 Constipation is a very common problem.

    00:33 It affects up to half of the general population and has a much higher prevalence in certain populations such as women, the elderly and patients in nursing homes.

    00:45 So because it's something you will encounter very frequently, you should know the important historical risk factors you should ask your patients about.

    00:52 So having an age greater than 50 years at the onset, rectal bleeding, unexplained weight loss, a family or personal history of colon cancer or a personal history of abdominal surgery, cancer or irradiation.

    01:09 All of these risk factors may prompt you to be a bit more concerned about the typical patient coming in with constipation.

    01:17 If multiple risk factors are present, you should consider referring that patient for colonoscopy.

    01:25 So, there are several different types of constipation.

    01:29 First we can divide this by primary constipation and secondary constipation from other causes.

    01:36 So under primary constipation, there is slow transit when stool just takes a long time to transit through the colon.

    01:44 Patients may also have what's called dyssynergic defecation.

    01:48 This is when they have the urge to defecate but then they have difficulty expelling stool from the anal rectum.

    01:56 Lastly, patients may have irritable bowel syndrome.

    01:58 This is when they have alterations in their bowel habits along with abdominal pain.

    02:05 Under the category of secondary constipation, is the umbrella of medications.

    02:10 Many medications can cause constipation.

    02:13 The most common culprit is opioid medications.

    02:17 Patients may also have endocrine or metabolic disorders that can contribute to constipation, or neurologic disorders.

    About the Lecture

    The lecture Constipation: Definition and Types by Kelley Chuang, MD is from the course Approach to Patients with GI Symptoms.

    Included Quiz Questions

    1. Opioids
    2. Irritable bowel syndrome
    3. Slow transit time
    4. Dyssynergic defecation
    5. Colon cancer

    Author of lecture Constipation: Definition and Types

     Kelley Chuang, MD

    Kelley Chuang, MD

    Customer reviews

    5,0 of 5 stars
    5 Stars
    4 Stars
    3 Stars
    2 Stars
    1  Star