Investigation and management of constipation.

Clinical Medicine Vol 2 No 5 September/October 2002 415 The term ‘constipation’ is used to describe a reduction in frequency of bowel movements by only one-third of sufferers. The others use the term to explain the need to strain or the passage of a hard motion. A tighter consensus has been agreed, termed the Rome definition (Table 1)1. Most patients (90%) have ‘simple constipation’ and do not seek specialist help in the investigation of their symptoms which respond to dietary adjustments, an increase in fluid intake or the use of laxatives. For the remainder, it is important to exclude secondary causes before considering referral for specialist investigation.