Recognizing and Defining Occasional Constipation: Consensus Recommendations

Highlights

A panel of leading gastroenterologists from five countries proposes a new definition of “occasional constipation”: intermittent symptomatic alteration in bowel habits that includes a reduction in frequency and/or difficulty in defecating without alarming features.
The new definition also liberalizes the duration (i.e., days to weeks) and response to treatment (i.e., lifestyle modifications and/or use of over-the-counter medications). This allows flexibility and individual heterogeneity that still conforms to the Rome IV guidelines.
By proposing a new definition of “occasional constipation,” the authors highlight existing knowledge gaps and recognize the variability of this entity across the patient population. Allowing new research to incorporate this definition will help elucidate a more definitive disease entity in the future.

Summary

Constipation is a common problem, affecting 15% of the population and is often self-diagnosed and self-managed. Over the past 3 decades, there have been significant advances in our understanding and management of chronic constipation, with emerging recognition that occasional constipation (OC) is another subtype that falls outside current classifications.

A new definition of CO has been developed, based on expert consensus and taking into account the multifactorial nature of the problem, such as alterations in intestinal habit that include the frequency of bowel movements and difficulty defecating. patient perception, duration of symptoms, and potential responsiveness to treatment.

Leading gastroenterologists from 5 countries met virtually on multiple occasions, including through an online digital platform to discuss the problem of OC and recommend a practical and easy-to-use definition:

"CO can be defined as intermittent or occasional symptomatic alterations in bowel habits. This includes an annoying reduction in the frequency of bowel movements and/or difficulty passing stools, but without alarming characteristics."

Bowel symptoms may last a few days or a few weeks, and episodes may require modification of lifestyle, dietary habits, and/or use of over-the-counter laxatives or bulking agents to restore a satisfactory bowel habit.

Prospective studies are required to validate this definition and determine the prevalence of OC in the community.

Recognizing and Defining Occasional Constipation: Consensus Recommendations

Consensus recommendations provide clarity on recognizing and defining occasional constipation, aiding in clinical practice.