Adult constipation

Rationale

Constipation is common in adult patients and can be attributed to several possible functional and organic causes. It may have a significant effect on quality of life and may be the presenting feature of significant pathology.

Causal Conditions

(list not exhaustive)

1. Diet and lifestyle
2. Irritable bowel syndrome
3. Drugs
4. Neurogenic (central or peripheral)
5. Myopathic
6. Metabolic
7. Pregnancy
8. Obstructive lesions
9. Anorectal disease

Key Objectives

Given an adult patient with constipation, the candidate will diagnose the cause and severity and will initiate an appropriate management plan.

Enabling Objectives

Given an adult patient with constipation, the candidate will

1. list and interpret critical clinical findings, including the features of the patient’s history and physical examination that distinguish functional from organic causes;
2. list and interpret critical investigations, including investigations required to determine whether the patient needs endoscopic examination or diagnostic imaging; and
3. construct an effective initial management plan, including
   1. putting in place a conservative plan of symptom management (e.g., dietary and lifestyle changes, appropriate medication use);
   2. outlining a plan for managing constipation that is secondary to medications;
   3. determining whether the patient requires specialized care; and
   4. implementing prevention strategies (e.g., dietary changes, behaviour modification).