Diagnosis
ÎAssessments of colonic transit and anorectal functions are useful for categorizing constipated patients into three groups, ie, normal transit or irritable bowel syndrome, pelvic floor dysfunction (ie, dyssynergic defecation), and slow transit constipation.
• Colonic transit is often delayed in patients with defecation disorders.
Table 1. Alarm Symptoms/Signs in Patients with Chronic Constipation
Blood in stool including positive fecal occult blood test Family history of colon cancer Family history of inflammatory bowel disease Anemia Weight loss ≥ 10 pounds Severe, persistent constipation that is unresponsive to treatment New onset constipation in an elderly patient without primary cause Abdominal or rectal mass
Bristol Stool Form Scale Type 1 Type 2 Type 3 Type 4 Type 5 Type 6 Type 7 Separate hard lumps, like nuts (hard to pass) Sausage-shaped, but lumpy Like a sausage but with cracks on its surface Like an Italian sausage or snake, smooth and soft Soft blobs with clear cut edges (passed easily) Fluffy pieces with ragged edges, a mushy stool Watery, no solid pieces. Entirely liquid
Copyright Rome Foundation, Bristol Stool Form Scale developed by Dr Ken Heaton, University of Bristol, UK.
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