Functional constipation

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Mugilan Poongkunran M.B.B.S [2]

Overview

Functional constipation is a form of constipation with a psychological or psychosomatic background. A person suffering from it is physiologically healthy, but still experiences trouble defecating. Functional constipation is medically defined by the Rome III criteria.

Rome III Criteria for Functional Constipation

Any 2 of the following
Less than three evacuations per week
Lumpy or hard stools in ≥ 25% of defecations
Straining during ≥ 25% of defecations
Anorectal obstruction sensation for ≥ 25% of defecations
Manual maneuvers to facilitate ≥ 25% of defecations
Incomplete evacuation sensation for ≥ 25% of defecations
Loose stools are not present
Insufficient criteria for irritable bowel syndrome

† Criteria fulfilled for the past 3 months and symptom onset at least 6 months before diagnosis.

American Gastroenterological Association, however have stopped using the term functional constipation because a subset these patients have slow colonic transit that has been associated with a marked reduction in colonic intrinsic nerves and interstitial cells of Cajal which is against the true definition of functional disorder.

Causes

Functional constipation has many causes, some of which are:

• a bad diet
• an unwillingness to defecate
• nervous reactions, including prolonged and/or chronic stress and anxiety, that close the inner anal sphincter muscle, which isn't under voluntary control
• inability or unwillingness to control one's outer anal sphincter, which is normally under voluntary control
• deeper psychosomatic disorders which sometimes affect digestion and the absorption of water in the colon

References

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