Chronic idiopathic constipation

Chronic Idiopathic Constipation

Chronic Idiopathic Constipation (CIC) is a common gastrointestinal disorder characterized by persistent difficulty in bowel movements, infrequent stools, or a sensation of incomplete evacuation, without an identifiable underlying cause. The term "idiopathic" indicates that the constipation is not due to any identifiable medical condition or medication.

Symptoms

Patients with chronic idiopathic constipation typically experience:

• Fewer than three bowel movements per week.
• Hard or lumpy stools.
• Straining during bowel movements.
• A sensation of incomplete evacuation.
• Abdominal discomfort or bloating.

Diagnosis

The diagnosis of CIC is primarily clinical, based on patient history and symptomatology. The Rome IV criteria are often used to diagnose functional gastrointestinal disorders, including CIC. These criteria require that symptoms be present for at least six months, with symptom onset at least three months prior to diagnosis.

Differential Diagnosis

It is important to rule out other causes of constipation, such as:

• Irritable Bowel Syndrome (IBS)
• Hypothyroidism
• Colorectal cancer
• Neurological disorders
• Medication-induced constipation

Treatment

Treatment for CIC often involves a combination of lifestyle modifications, dietary changes, and pharmacological interventions.

Lifestyle and Dietary Changes

• Increasing dietary fiber intake through fruits, vegetables, and whole grains.
• Ensuring adequate hydration.
• Regular physical activity.

Pharmacological Treatments

• Laxatives: Bulk-forming, osmotic, stimulant, and stool softeners.
• Prescription medications: Such as lubiprostone, linaclotide, and plecanatide, which are specifically approved for CIC.

Prognosis

The prognosis for individuals with CIC varies. While some patients may experience significant relief with treatment, others may have persistent symptoms. Long-term management often requires ongoing lifestyle and dietary modifications.

Research and Future Directions

Ongoing research is focused on understanding the pathophysiology of CIC, including the role of the gut microbiome and genetic factors. New therapeutic agents are also being developed to improve symptom management.

Also see

• Functional gastrointestinal disorders
• Rome IV criteria
• Irritable Bowel Syndrome
• Laxatives