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KMID : 1812020230290030271
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Journal of Neurogastroenterology and Motility
2023 Volume.29 No. 3 p.271 ~ p.305
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2022 Seoul Consensus on Clinical Practice Guidelines for Functional Constipation
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Cho Young-Sin
Lee Yoo-Jin
Shin Jeong-Eun
Jung Hye-Kyung
Park Seon-Young
Kang Seung-Joo
Song Kyung-Ho
Kim Jung-Wook
Lim Hyun-Chul
Park Hee-Sun
Kim Seong-Jung
Cha Ra-Ri
Bang Ki-Bae
Bang Chang-Seok
Yim Sung-Kyun
Ryoo Seung-Bum
Kye Bong Hyeon
Ji Woong-Bae
Choi Mi-Young
Sung In-Kyung
Choi Suck-Chei
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Abstract
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Chronic constipation is one of the most common digestive diseases encountered in clinical practice. Constipation manifests as a variety of symptoms, such as infrequent bowel movements, hard stools, feeling of incomplete evacuation, straining at defecation, a sense of anorectal blockage during defecation, and use of digital maneuvers to assist defecation. During the diagnosis of chronic constipation, the Bristol Stool Form Scale, colonoscopy, and a digital rectal examination are useful for objective symptom evaluation and differential diagnosis of secondary constipation. Physiological tests for functional constipation have complementary roles and are recommended for patients who have failed to respond to treatment with available laxatives and those who are strongly suspected of having a defecatory disorder. As new evidence on the diagnosis and management of functional constipation emerged, the need to revise the previous guideline was suggested. Therefore, these evidence-based guidelines have proposed recommendations developed using a systematic review and meta-analysis of the treatment options available for functional constipation. The benefits and cautions of new pharmacological agents (such as lubiprostone and linaclotide) and conventional laxatives have been described through a meta-analysis. The guidelines consist of 34 recommendations, including 3 concerning the definition and epidemiology of functional constipation, 9 regarding diagnoses, and 22 regarding managements. Clinicians (including primary physicians, general health professionals, medical students, residents, and other healthcare professionals) and patients can refer to these guidelines to make informed decisions regarding the management of functional constipation.
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KEYWORD
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Constipation, Diagnosis, Guideline, Meta-analysis, Therapeutics
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