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Six key symptoms of constipation … and how to avoid it

Updated 06.06.2013 9:23:18 CET


A new study by King's College London, published in the American Journal of Gastroenterology, found that the perception of constipation from the public is dramatically different from that of doctors and formal diagnostic guidance. They also identified six key sets of symptoms common to both that could form the basis of the new medical definition of constipation in the future.

Constipation is a very common condition and although most people with chronic constipation do not visit a doctor, they are diagnosed in more than one million medical consultations and have 63,000 hospital admissions in the UK every year.

However, the way it is detected varies considerably. Some patients themselves diagnose themselves, some doctors diagnose pragmatic, others use formal criteria (such as Rome IV), which lists combinations of symptoms that occur within certain time periods.

The lead author, Dr. Irini Dimidi, an associate researcher at Royal College London, recalls that "previous studies have tried to estimate how many people are suffering from constipation, but their results vary between 3% and 35%. A potential cause for this range is the lack of a consistent method to diagnose. In the moment, Prescription drugs for constipation fail in almost 60% of patients and nearly half reported that they were not happy with their treatment. "

The Royal College team collected data from 2,557 people (934 of whom had self-reported constipation), 411 doctors and 365 specialists in gastroenterology.

They found that in those who reported constipation, 94% met formal diagnostic criteria. However, surprisingly, out of 1,623 who have not self-diagnosed constipation, 29% also meet these criteria. Hence, almost one in three "healthy" patients were clinically closed, but did not recognize it.

Using case studies, The correct rates for diagnosis of constipation range from 99% to 39% depending on the symptoms present. For example, rare bowel movements were considered important for diagnosing constipation in less than one-third of the population, compared with 41% of GPs and up to 65% of medical specialists.

The study also noted six sets of key symptoms which were agreed in all study groups:

– abdominal discomfort, pain and abdominal distension

– Rectal discomfort

– Rare movements of the colon and hard chairs

– Sensory dysfunction

– The spacecraft

– Fecal incontinence

Professor Kevin Willan, head of the Royal College of London's Department of Nutrition, notes that the study "found that a number of symptoms are considered important for diagnosis of constipation in the general population that is not part of any criterion of current diagnoses or assessment tools . With significant differences between patients and doctors"

"This is important because patients who seek medical treatment for constipation symptoms may not recognize symptoms as constipation by the physician and therefore can not be managed as such," he said. significantly affect patient access to care and treatment ".


Dr. Pedro Machado Leendo, Coloproctology Specialist at the Department of General Surgery and Digestive Diseases at the Quironsalod San Jose Hospital, seven practical keys to prevent this from happening:

1. A diet rich in fiber (fruits, vegetables and cereals): Take at least two pieces a day. "In fruits, the best are kiwi and plums, you must avoid the banana and apple without skin because they are astringent," said a specialist.

2. Drink at least two liters of water / day (eight glasses): this quantity is used for a whole year, although in the summer you need to increase the intake of fluid, because it increases the possibility of dehydration due to environmental conditions.

3. Consume 1-2 tablespoons (15-30 g.) Wheat bran mixed with yogurt, then a glass of water (at any time of the day).

4. Reduce the intake of processed foods: "You need to focus more on foods and recipes containing whole grains and less to those who carry refined flour," says Dr. Machado Leendo.

5. Practice physical exercises regularly: those people who due to physical problems or medical contraindications can not perform sports activities should go at least 30 minutes a day.

6. Avoid delayed walking in the bathroom when a defect is required: "We need to take care when we leave our daily routine (for example, on vacation), because we usually postpone the act of defecation because of modesty, shame, etc." said the surgeon, who recommends avoiding defecation.

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