GPAtlas🧭 When to suspect
Constipation is unsatisfactory defecation – infrequent stools, difficult or painful passage, or a sense of incomplete emptying. It is best thought of as a symptom, not a disease, and what counts as "normal" varies widely (anything from three times a day to three times a week). It is common, affecting roughly 1 in 7 adults, and is more frequent in women, older people, and during pregnancy.
The single most useful split is functional (primary/idiopathic) constipation – the large majority – versus secondary constipation caused by a drug or an underlying condition. The two clinical skills that matter in primary care are therefore: exclude red flags and reversible causes, then treat with lifestyle measures and a titrated laxative. Most cases need no investigation at all.
| Suspect constipation when two or more are present |
|---|
|
• Fewer than three bowel movements per week |
|
• Hard or lumpy stools – Bristol Stool Form Scale type 1–2 |
|
• Excessive straining to pass stool |
|
• Sensation of incomplete evacuation or anorectal blockage |
|
• Need for manual manoeuvres (digitation, perineal support) to pass stool |
Symptoms persisting longer than three months define chronic constipation. New, persistent constipation in anyone over 50 – or at any age with weight loss, bleeding, or anaemia – needs active exclusion of malignancy before being labelled functional.
Source: NICE
🔒 Sign up free to read the full topic
You're viewing a free preview. Create a free account to unlock the rest.
Sign up free →Sample topics are open to everyone in the Free Sample Bundle.