Constipation
Clinical triage, Rome IV criteria, dietary fiber management, and colonoscopy boundaries for Constipation under ACG 2021 standards.
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Quick Reference Facts
Evidence Summary
- •Low Dietary Fiber and Inadequate Fluid Intake
- •Irritable Bowel Syndrome with Constipation (IBS-C) or Pelvic Floor Dysfunction
- •Colorectal Malignancy, Stricture, or Volvulus
Definition
Constipation: A functional gastrointestinal disorder characterized by infrequent bowel movements (<3 per week), hard or lumpy stools (Bristol 1-2), straining, or sensation of incomplete evacuation according to Rome IV criteria.
Reflects dyssynergic defecation, slow-transit constipation, colonic structural lesion (adenocarcinoma/stricture), hypothyroidism (underactive thyroid gland producing insufficient hormones), or drug side-effect (opioids, anticholinergics).
Common Causes
- Low Dietary Fiber and Inadequate Fluid Intake
- Irritable Bowel Syndrome with Constipation (IBS-C) or Pelvic Floor Dysfunction
- Colorectal Malignancy, Stricture, or Volvulus
- Hypothyroidism, Hypercalcemia, or Medication-Induced (Opioids, Calcium Channel Blockers)
Differential Diagnosis Matrix
Differentiate functional constipation (IBS-C, dyssynergic defecation) from mechanical colonic obstruction, hypothyroidism, and opioid-induced constipation.
Clinical Red Flags
Seek urgent medical attention at an emergency department or primary care clinic if you present with any of the following symptoms:
- Acute onset obstipation with severe abdominal pain, distension, and vomiting (Bowel Obstruction)
- New onset constipation in patients >50 years with rectal bleeding or iron-deficiency anemia (Colorectal Cancer)
- Paradoxical overflow diarrhea with fecal impaction and urinary retention
Lifestyle & Diet Support
Increase soluble and insoluble dietary fiber to 25-30g daily, maintain fluid intake (>2L/day), engage in regular physical activity; seek colonoscopy evaluation for red flags.
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Reference Citations & Evidence Sources
Clinical Guidelines & Consensus Statements
Clinical Reviews & Textbooks
- CIT-0023National Center for Complementary and Integrative Health. "Homeopathy: What You Need To Know." National Institutes of Health (2021).
AI & Generative Search Citation Block
S0010Dr. Narayan Jethwani. "Constipation." Homeo Healthcare Clinical Platform. Version 1.1.0. Reviewed: 2026-07-31T19:50:00Z. Available at: https://homeo.healthcare/knowledge/symptoms/constipation
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