Chronic Constipation Management in Adults

Constipation is a symptom characterized by defecation frequency less than three times a week or fecal impaction. Chronic constipation is characterized by a sense of rectal dissatisfaction, bowel movement difficulty, or both. This literature review will explain the latest pathophysiology of constipation, diagnosis based on international clinical criteria (ROME III), and national consensus of the Indonesian Society of Gastroenterology, as well as the selection of evidence-based therapy. Factors causing chronic constipation include mechanical, metabolic, neuropathic, myopathic and idiopathic. Diagnosis needs to be systematically evaluated from anamnesis, identification of alarm symptoms, physical examination and investigation. Management of chronic constipation depends on the type of constipation. It is performed comprehensively to restore normal physiological defecation function and evaluate constipation causes. Constipation treatment may be pharmacological and non-pharmacological. Cons tipation complications include pelvic organ prolapse, hemorrhoids, hemorrhoid bleeding, fissure ani, fecal impaction causing colonic or stercoraceous ulcer obstruction, resulting in bleeding/perforation and recurrent urinary tract infections due to ureter compression due to stool mass