Chronic constipation : Further investigations

Chronic constipation is a common gastrointestinal disorder characterized by infrequent bowel movements or difficult passage of stools that persists for several weeks or longer. According to the Rome IV criteria, chronic constipation is defined by the presence of two or more of the following symptoms for at least three months with symptom onset at least six months prior to diagnosis:

1. Straining during more than 25% of defecations.
2. 
   
3. Lumpy or hard stools in more than 25% of defecations.
4. Sensation of incomplete evacuation in more than 25% of defecations.
5. Sensation of anorectal obstruction/blockage in more than 25% of defecations.
6. Manual maneuvers to facilitate more than 25% of defecations (e.g., digital evacuation, support of the pelvic floor).
7. Fewer than three spontaneous bowel movements per week.
8. 
   

Additionally, the criteria specify that loose stools should rarely be present without the use of laxatives, and there should be insufficient criteria for irritable bowel syndrome (IBS)​ (Division of Digestive and Liver Diseases)​​ (Newcastle Hospitals NHS Foundation Trust)​.

Chronic constipation can significantly impact quality of life and may lead to complications such as hemorrhoids, anal fissures, or fecal impaction. It can be caused by a variety of factors including dietary habits, lifestyle, medications, and...