Functional constipation
| Functional constipation | |
|---|---|
| Synonyms | Chronic idiopathic constipation | 
| Pronounce | N/A | 
| Specialty | N/A | 
| Symptoms | Infrequent bowel movements, hard stools, straining during defecation | 
| Complications | Hemorrhoids, anal fissures, fecal impaction | 
| Onset | Any age, more common in children and elderly | 
| Duration | Long-term | 
| Types | N/A | 
| Causes | Unknown, possibly dietary factors, lifestyle, psychological factors | 
| Risks | Low fiber diet, sedentary lifestyle, dehydration | 
| Diagnosis | Based on Rome IV criteria, physical examination, medical history | 
| Differential diagnosis | Irritable bowel syndrome, obstructive defecation syndrome, colonic inertia | 
| Prevention | N/A | 
| Treatment | Dietary changes, laxatives, behavioral therapy | 
| Medication | Osmotic laxatives, stimulant laxatives, stool softeners | 
| Prognosis | N/A | 
| Frequency | Common | 
| Deaths | Rare | 
Functional Constipation
Functional constipation is a common digestive disorder that affects individuals of all ages. It is characterized by infrequent bowel movements, difficulty passing stools, or the sensation of incomplete evacuation. Unlike other forms of constipation, functional constipation does not have an identifiable organic cause. It is diagnosed based on symptoms and the exclusion of other gastrointestinal disorders.
Causes and Risk Factors
The exact cause of functional constipation is not well understood, but it is believed to involve slow movement of stool through the colon. Several factors can increase the risk of developing functional constipation, including:
- Low fiber intake
 - Inadequate hydration
 - Limited physical activity
 - Certain medications
 - Stress and psychological factors
 - Aging
 
Symptoms
Symptoms of functional constipation may include:
- Less than three bowel movements per week
 - Hard, dry, or lumpy stools
 - Difficulty or straining during bowel movements
 - Feeling of incomplete evacuation after a bowel movement
 - Abdominal discomfort or bloating
 
Diagnosis
Diagnosis of functional constipation is primarily based on the Rome IV criteria, which are standardized diagnostic criteria for functional gastrointestinal disorders. A healthcare provider may also perform a physical examination and order tests to rule out other conditions, such as:
- Blood tests
 - Colonoscopy
 - Anorectal manometry
 
Treatment
Treatment for functional constipation often involves lifestyle and dietary changes, such as:
- Increasing dietary fiber intake
 - Drinking more fluids
 - Engaging in regular physical activity
 - Establishing regular bowel habits
 
In some cases, over-the-counter or prescription medications may be recommended, including:
- Laxatives
 - Fiber supplements
 - Stool softeners
 - Lubricants
 
Prevention
Preventive measures for functional constipation include maintaining a healthy diet rich in fiber, staying hydrated, exercising regularly, and avoiding prolonged periods of inactivity.
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Contributors: Prab R. Tumpati, MD