Functional constipation

Functional constipation, also known as chronic idiopathic constipation (CIC), is defined by less than three <a href="/facts/Bowel_movements/EBv8o15S">bowel movements</a> per week, hard stools, severe straining, the sensation of anorectal blockage, the feeling of incomplete evacuation, and the need for manual maneuvers during <a href="/facts/Feces/r9HDKB8G">feces</a>, without organic abnormalities. Many illnesses, including <a href="/facts/Endocrine_disease/nDuNHkJY">endocrine</a>, <a href="/facts/Metabolic_syndrome/jI70tRBv">metabolic</a>, <a href="/facts/Neurological_disorder/eQKKs7jX">neurological</a>, <a href="/facts/Mental_disorder/EPNjFtFf">mental</a>, and gastrointestinal obstructions, can cause <a href="/facts/Constipation/l4DHHM6L">constipation</a> as a secondary symptom. When there is no such cause, functional constipation is diagnosed.
Functional constipation requires symptoms to be present at least a fourth of the time. Causes include <a href="/facts/Anismus/Xo1qjCoD">anismus</a>, <a href="/facts/Descending_perineum_syndrome/UHxngmFa">descending perineum syndrome</a>, inability to control the external anal sphincter, poor diet, unwillingness to defecate, nervous reactions, and deep <a href="/facts/Somatic_symptom_disorder/UpmecJfr">psychosomatic disorders</a>. Comorbid symptoms such as <a href="/facts/Headache/mdmmC9DP">headache</a> may also be present, especially in children.
Functional constipation is diagnosed using the <a href="/facts/Rome_process/sb0lqgxX">Rome criteria</a>, a consensus of experts. The criteria include over 25% of defecations involving straining, 25% resulting in lumpy or hard stools, 25% requiring partial evacuation, 25% experiencing anorectal blockage or obstruction, and 25% using manual techniques. Less than three weekly spontaneous bowel movements are also considered. A thorough history and physical examination, including a <a href="/facts/Rectal_examination/zYJcnBxD">digital rectal exam</a>, is crucial for diagnosing constipation. Additional laboratory testing is typically used in cases of uncertainty or to rule out underlying medical conditions.
Functional constipation is a condition that requires nonpharmacological management, including education and lifestyle modifications. It begins with dietary guidelines, focusing on regular <a href="/facts/Fiber/ttkxAFBu">fiber</a> and fluid intake. Children with functional constipation should consume a normal intake of fiber, as per ESPGHAN/NASPGHAN criteria. Parents and children should receive counseling about <a href="/facts/Overflow_incontinence/e5SBJN4N">overflow incontinence</a> and withholding behavior. An organized toilet-training program with a reward system can help reduce faecal impaction.
Pharmacological treatment for children with functional constipation consists of maintenance therapy and faecal disimpaction. High-dose oral <a href="/facts/Polyethylene_glycol/tC7xBFwr">polyethylene glycol</a> (PEG) or <a href="/facts/Enema/SnMcGgul">enemas</a> containing active substances can induce fecal disimpaction, while maintenance therapy is recommended after successful disimpaction to avoid reoccurring stool buildup. <a href="/facts/Glycerine/sRQ6NBQQ">Glycerine</a> or <a href="/facts/Bisacodyl/t1RTJTmm">bisacodyl</a> suppositories are also used for both adults and children. Maintenance treatment for functional constipation includes osmotic laxatives, <a href="/facts/Milk_of_magnesia/0hKR5Ica">milk of magnesia</a>, and mineral oil. Stimulant laxatives such as senna or bisacodyl are recommended for those with persistent symptoms.

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Functional constipation