The problem of constipation in the practice of an outpatient doctor

Abstract

Constipation is a disorder that affects a large number of people and has a negative impact on quality of life. Constipation is one of the common reasons for seeking medical help from an outpatient doctor. The problem of constipation can often be multifactorial, with important causes being low fiber in the diet, decreased fluid intake and physical inactivity. For some patients, constipation is not a chronic problem, but may occur at some point in their lives, usually lasts a limited period of time and is not a serious problem, the solution to which may be changes in diet and lifestyle, or a short course of laxatives. In everyday outpatient practice, so-called simple or functional constipation is more common. At the same time, long-term or chronic constipation is often a complex problem for both the doctor and the patient; it is often secondary in nature, affecting not only personal well-being and quality of life, but also causes considerable financial costs, since most patients do not immediately seeks medical help, trying to self-medicate, for a long time and not always successfully, transforming the problem into a chronic one, further complicating the diagnostic search and choice of treatment tactics. Chronic constipation is more often a problem for women and older people. Knowledge and understanding of the causes and possibilities for diagnosing constipation, approaches to therapy, as well as measures for its prevention will allow the outpatient doctor to choose the necessary tactics for managing the patient. The article provides a review of the literature on the etiopathogenetic, diagnostic aspects of constipation, as well as the possibility of an integrated approach in the treatment of patients. Algorithms for diagnostic search and choice of therapy for a patient with constipation are convenient for practical use, which is also presented in the article.