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Diagnosing Constipation Spectrum Disorders in a Primary Care Setting

Understanding pathophysiological causes of constipation is worthwhile in directing therapy and improving symptoms. This review aims to identify and fill gaps in the understanding of the pathophysiology of constipation, understand its prevalence, review diagnostic tools available to primary care phys...

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Detalles Bibliográficos
Autores principales: Heidelbaugh, Joel, Martinez de Andino, Nicole, Pineles, David, Poppers, David M.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7961346/
https://www.ncbi.nlm.nih.gov/pubmed/33807888
http://dx.doi.org/10.3390/jcm10051092
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author Heidelbaugh, Joel
Martinez de Andino, Nicole
Pineles, David
Poppers, David M.
author_facet Heidelbaugh, Joel
Martinez de Andino, Nicole
Pineles, David
Poppers, David M.
author_sort Heidelbaugh, Joel
collection PubMed
description Understanding pathophysiological causes of constipation is worthwhile in directing therapy and improving symptoms. This review aims to identify and fill gaps in the understanding of the pathophysiology of constipation, understand its prevalence, review diagnostic tools available to primary care physicians (PCPs), and highlight patients’ expectations for the management of this common spectrum of disorders. Literature searches conducted via PubMed included terms related to constipation, diagnosis, and patient perceptions. Case studies were developed to highlight the differences between patients who may be appropriately managed in the primary care setting and those requiring specialty consultation. Myriad pathophysiological factors may contribute to constipation, including stool consistency, altered intestinal motility, gut microbiome, anorectal abnormalities, as well as behavioral and psychological factors. Common diagnoses of “primary constipation” include slow-transit constipation, defecation disorders, irritable bowel syndrome with constipation, and chronic idiopathic constipation. A detailed medical history should be conducted to exclude alarm features and PCPs should be familiar with pathophysiological factors that cause constipation, available diagnostic tools, alarm signs, and the various classification criteria for constipation subtypes in order to diagnose and treat patients accordingly. PCPs should understand when a referral to a gastroenterologist, anorectal specialist, pelvic floor physical therapist, and/or mental health specialist is appropriate.
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spelling pubmed-79613462021-03-17 Diagnosing Constipation Spectrum Disorders in a Primary Care Setting Heidelbaugh, Joel Martinez de Andino, Nicole Pineles, David Poppers, David M. J Clin Med Review Understanding pathophysiological causes of constipation is worthwhile in directing therapy and improving symptoms. This review aims to identify and fill gaps in the understanding of the pathophysiology of constipation, understand its prevalence, review diagnostic tools available to primary care physicians (PCPs), and highlight patients’ expectations for the management of this common spectrum of disorders. Literature searches conducted via PubMed included terms related to constipation, diagnosis, and patient perceptions. Case studies were developed to highlight the differences between patients who may be appropriately managed in the primary care setting and those requiring specialty consultation. Myriad pathophysiological factors may contribute to constipation, including stool consistency, altered intestinal motility, gut microbiome, anorectal abnormalities, as well as behavioral and psychological factors. Common diagnoses of “primary constipation” include slow-transit constipation, defecation disorders, irritable bowel syndrome with constipation, and chronic idiopathic constipation. A detailed medical history should be conducted to exclude alarm features and PCPs should be familiar with pathophysiological factors that cause constipation, available diagnostic tools, alarm signs, and the various classification criteria for constipation subtypes in order to diagnose and treat patients accordingly. PCPs should understand when a referral to a gastroenterologist, anorectal specialist, pelvic floor physical therapist, and/or mental health specialist is appropriate. MDPI 2021-03-05 /pmc/articles/PMC7961346/ /pubmed/33807888 http://dx.doi.org/10.3390/jcm10051092 Text en © 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Heidelbaugh, Joel
Martinez de Andino, Nicole
Pineles, David
Poppers, David M.
Diagnosing Constipation Spectrum Disorders in a Primary Care Setting
title Diagnosing Constipation Spectrum Disorders in a Primary Care Setting
title_full Diagnosing Constipation Spectrum Disorders in a Primary Care Setting
title_fullStr Diagnosing Constipation Spectrum Disorders in a Primary Care Setting
title_full_unstemmed Diagnosing Constipation Spectrum Disorders in a Primary Care Setting
title_short Diagnosing Constipation Spectrum Disorders in a Primary Care Setting
title_sort diagnosing constipation spectrum disorders in a primary care setting
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7961346/
https://www.ncbi.nlm.nih.gov/pubmed/33807888
http://dx.doi.org/10.3390/jcm10051092
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