Diagnosis
For a diagnosis of chronic idiopathic constipation (CIC), symptoms should be “chronic” (persisting at least six months), and “idiopathic”, lacking another known cause.2,6 Patients should experience two or more of the following symptoms:2,6,7
- less than 3 bowel movements per week
- ≥25% of bowel movements affected by lumpy or hard stools
- ≥25% of bowel movements affected by straining
- ≥25% of bowel movements affected by sensation of incomplete evacuation
- ≥25% of bowel movements affected by sensation of anorectal blockage
- ≥25% of bowel movements affected by use of manual maneuvers to facilitate defecation
Additionally, patients with CIC rarely have loose stools without use of a laxative, and have insufficient criteria for irritable bowel syndrome.2,6,7
CIC can be further divided into 3 subtypes largely based on further physiologic testing: dyssynergic defecation (outlet obstruction), slow transit constipation (STC) and normal transit constipation (NTC).7,8,9