American Gastroenterological Association Technical Review on Constipation

      Constipation is a very common symptom. Prompted by several advances since the last technical review 15 years ago,
      • Locke III, G.R.
      • Pemberton J.H.
      • Phillips S.F.
      AGA technical review on constipation.
      this update will identify a rational, efficacious, and ideally cost-effective approach to patients with constipation. Toward those objectives, the epidemiology, clinical assessment, diagnostic testing, and management of constipation will be discussed, primarily from the perspective of a practicing gastroenterologist. Constipation in children and secondary constipation (eg, due to spinal cord injury) in adults will not be specifically addressed. This review was prepared by updating the previous technical review with material sourced from recent reviews on chronic constipation,
      • Ford A.
      • Suares N.
      Effect of laxatives and pharmacological therapies in chronic idiopathic constipation: systematic review and meta-analysis.
      • Camilleri M.
      • Bharucha A.E.
      Behavioural and new pharmacological treatments for constipation: getting the balance right.
      • Mugie S.M.
      • Benninga M.A.
      • Di Lorenzo C.
      Epidemiology of constipation in children and adults: a systematic review.
      supplemented by selected and focused literature searches of peer-reviewed, published studies. Although recommendations are graded based on US Preventive Services Task Force (USPSTF) ratings, formal cost-effectiveness analyses have not been performed. Comparisons of diagnostic approaches, with precise estimates of specificity and sensitivities, also have not been published. Indeed, in some instances, individual diagnostic techniques have not even been standardized.

      Abbreviations used in this paper:

      AGA (American Gastroenterological Association), CFTR (cystic fibrosis transmembrane regulator), FDA (Food and Drug Administration), IBS (irritable bowel syndrome), IBS-C (constipation-predominant irritable bowel syndrome), IRA (ileorectal anastomosis), NTC (normal transit constipation), STARR (stapled transanal resection), STC (slow transit constipation)
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