Constipation history and symptoms: Difference between revisions
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{{Constipation}} | {{Constipation}} | ||
{{CMG}}; {{AE}}{{EG}} | |||
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==Overview== | ==Overview== | ||
A positive history of straining, hard [[stools]], sensation of incomplete evacuation, sensation of [[anorectal]] [[obstruction]], use of manual maneuvers, and less than 3 [[Defecation|defecations]] weekly is suggestive of constipation. The most common symptoms of constipation include infrequent [[Bowel movement|bowel movements]], [[Bloating|abdominal bloating]], necessity to strain, and [[anal pain]]. Less common symptoms of constipation include [[abdominal fullness]], visible [[abdominal distention]], incomplete evacuation, [[abdominal pain]], [[rectal bleeding]], and [[mass]] protrusion. [[Bristol Stool Scale|Bristol Stool Form Scale]] and Patient Assessment Constipation-Quality of Life (PAC-QOL) are two questionnaire based on patients [[symptoms]], help to diagnose constipation and [[quality of life]] in constipated patients. | |||
==History and Symptoms== | |||
*The hallmark of constipation is decreased number of [[Bowel movement|bowel movements]] and hardened [[stool]]. A positive history of straining, hard [[stools]], sensation of incomplete evacuation, sensation of [[anorectal]] [[obstruction]], use of manual maneuvers, and less than 3 [[Defecation|defecations]] weekly is suggestive of constipation. The most common [[symptoms]] of constipation include infrequent [[Bowel movement|bowel movements]], [[Bloating|abdominal bloating]], necessity to strain, and [[anal pain]]. | |||
===History=== | |||
Patients with constipation may have a positive history of:<ref name="Rao2008">{{cite journal|last1=Rao|first1=Satish S. C.|title=Approach to the Patient with Constipation|year=2008|pages=373–398|doi=10.1002/9781444300758.ch20}}</ref> | |||
*Straining | |||
*Lumpy or hard [[stools]] | |||
*Sensation of incomplete evacuation | |||
*Sensation of [[anorectal]] [[obstruction]] or blockage | |||
*Digital maneuvers | |||
*Less than 3 [[Defecation|defecations]] per week | |||
Specific areas of focus when taking history of patients with constipation include:<ref name="pmid21382584">{{cite journal| author=Rao SS, Meduri K| title=What is necessary to diagnose constipation? | journal=Best Pract Res Clin Gastroenterol | year= 2011 | volume= 25 | issue= 1 | pages= 127-40 | pmid=21382584 | doi=10.1016/j.bpg.2010.11.001 | pmc=3063397 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21382584 }}</ref> | |||
* [[Bowel]] habits description | |||
* Onset of [[symptoms]] | |||
* Duration of [[symptoms]] | |||
* Severity of [[symptoms]] | |||
* Precipitating events | |||
* [[Laxative]] use: Type, number, and frequency | |||
* Dietary history: Fiber and fluid intake | |||
* [[Family history]]: [[Bowel]] function | |||
{| align: " right | |||
|[[image:Bristol stool chart.svg.png|thumb|700px| Bristol Stool Scale- By Cabot Health, via Wikimedia Commons<ref><http://cdn.intechopen.com/pdfs-wm/46082.pdf> [CC BY-SA 3.0 <https://creativecommons.org/licenses/by-sa/3.0>]</ref>]] | |||
===Common Symptoms=== | |||
Common [[symptoms]] of constipation include:<ref name="pmid9269805">{{cite journal |vauthors=Koch A, Voderholzer WA, Klauser AG, Müller-Lissner S |title=Symptoms in chronic constipation |journal=Dis. Colon Rectum |volume=40 |issue=8 |pages=902–6 |year=1997 |pmid=9269805 |doi= |url=}}</ref> | |||
*Infrequent [[Bowel movement|bowel movements]] | |||
*[[Bloating|Abdominal bloating]] | |||
*Necessity to strain | |||
*[[Anal pain]] | |||
== | ==== Bristol Stool Form Scale ==== | ||
* The [[Bristol Stool Scale|Bristol Stool Form Scale]] is a tool to investigate the [[stool]] form and it helps to identify the colonic transit time. | |||
* Very hard [[stools]] may reflect the highest and watery [[stools]] may reflect the lowest colonic transit time.<ref name="pmid7930429">{{cite journal |vauthors=Heaton KW, O'Donnell LJ |title=An office guide to whole-gut transit time. Patients' recollection of their stool form |journal=J. Clin. Gastroenterol. |volume=19 |issue=1 |pages=28–30 |year=1994 |pmid=7930429 |doi= |url=}}</ref> | |||
==== Patient Assessment Constipation-Quality of Life (PAC-QOL) ==== | |||
* Patient Assessment Constipation-Quality of Life (PAC-QOL) is a questionnaire to evaluate the [[quality of life]] of patients with constipation. | |||
* PAC-QOL is completely based on the common symptoms of the patients with constipation.<ref name="pmid16036506">{{cite journal |vauthors=Marquis P, De La Loge C, Dubois D, McDermott A, Chassany O |title=Development and validation of the Patient Assessment of Constipation Quality of Life questionnaire |journal=Scand. J. Gastroenterol. |volume=40 |issue=5 |pages=540–51 |year=2005 |pmid=16036506 |doi=10.1080/00365520510012208 |url=}}</ref> | |||
===Less Common Symptoms=== | |||
Less common symptoms of constipation include:<ref name="MertzNaliboff1999">{{cite journal|last1=Mertz|first1=H.|last2=Naliboff|first2=B.|last3=Mayer|first3=E. A.|title=Symptoms and physiology in severe chronic constipation|journal=The American Journal of Gastroenterology|volume=94|issue=1|year=1999|pages=131–138|issn=0002-9270|doi=10.1111/j.1572-0241.1999.00783.x}}</ref> | |||
*[[Abdominal fullness]] | |||
*Visible [[abdominal distention]] | |||
*Incomplete evacuation | |||
*[[Abdominal pain]] | |||
*[[Rectal bleeding]] | |||
*Mass protrusion | |||
*[[Dry skin]] | |||
*[[Dysphagia]] | |||
*[[Polyuria]] | |||
*[[Polyphagia]] | |||
*[[Polydipsia]] | |||
*[[Tremor]] | |||
*[[Gait abnormality|Gait imbalance]] | |||
*[[Involuntary jerky movements|Involuntary movements]] | |||
*[[Weight loss]] | |||
*[[Weakness]] | |||
==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
{{WH}} | |||
{{WS}} | |||
|} | |||
[[Category:Gastroenterology]] | [[Category:Gastroenterology]] | ||
[[Category: | [[Category:Medicine]] | ||
[[Category: | [[Category:Up-To-Date]] | ||
[[Category: | [[Category:Emergency medicine]] | ||
Latest revision as of 21:07, 29 July 2020
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Eiman Ghaffarpasand, M.D. [2]
Overview
A positive history of straining, hard stools, sensation of incomplete evacuation, sensation of anorectal obstruction, use of manual maneuvers, and less than 3 defecations weekly is suggestive of constipation. The most common symptoms of constipation include infrequent bowel movements, abdominal bloating, necessity to strain, and anal pain. Less common symptoms of constipation include abdominal fullness, visible abdominal distention, incomplete evacuation, abdominal pain, rectal bleeding, and mass protrusion. Bristol Stool Form Scale and Patient Assessment Constipation-Quality of Life (PAC-QOL) are two questionnaire based on patients symptoms, help to diagnose constipation and quality of life in constipated patients.
History and Symptoms
- The hallmark of constipation is decreased number of bowel movements and hardened stool. A positive history of straining, hard stools, sensation of incomplete evacuation, sensation of anorectal obstruction, use of manual maneuvers, and less than 3 defecations weekly is suggestive of constipation. The most common symptoms of constipation include infrequent bowel movements, abdominal bloating, necessity to strain, and anal pain.
History
Patients with constipation may have a positive history of:[1]
- Straining
- Lumpy or hard stools
- Sensation of incomplete evacuation
- Sensation of anorectal obstruction or blockage
- Digital maneuvers
- Less than 3 defecations per week
Specific areas of focus when taking history of patients with constipation include:[2]
- Bowel habits description
- Onset of symptoms
- Duration of symptoms
- Severity of symptoms
- Precipitating events
- Laxative use: Type, number, and frequency
- Dietary history: Fiber and fluid intake
- Family history: Bowel function
![]() Common SymptomsCommon symptoms of constipation include:[4]
Bristol Stool Form Scale
Patient Assessment Constipation-Quality of Life (PAC-QOL)
Less Common SymptomsLess common symptoms of constipation include:[7]
References
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