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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...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2021
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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. |
format | Online Article Text |
id | pubmed-7961346 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
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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