Constipation in adults - triage

Constipation is a common gastrointestinal complaint among adults, characterized by a decrease in the frequency of bowel movements and/or difficulty passing stools. The diagnosis of constipation should be considered when an individual presents with defecation that is problematic due to infrequent stools, difficulty in stool passage, or a sensation of incomplete evacuation or anorectal blockage. While the threshold for defining constipation can vary, bowel movements occurring less than three times a week are typically indicative of this condition. However, it's important to note that constipation can also present with daily bowel movements accompanied by symptoms such as excessive straining, lower abdominal pain or discomfort, distension, or bloating, underscoring the variability in its presentation.

In clinical practice, constipation is often recognized not just by the reduction in bowel movement frequency but by a deviation from the individual's normal defecation pattern. This personalized approach acknowledges the wide range of normal bowel habits and focuses on changes that signify a departure from each person's baseline.

Particularly in the elderly, constipation might manifest through non-specific symptoms that could complicate the clinical picture. These symptoms include confusion or delirium, functional decline, nausea or loss of appetite, overflow diarrhoea, and urinary retention. Such presentations necessitate...