| Theme | Chronic Constipation : A New Classification, Pathophysiology, Diagnosis, Treatment | |
|---|---|---|
| Title | Definition, Classification, and Diagnostic Criteria for Constipation -- Japanese 2017 Guideline for the Management of Chronic Constipation | |
| Publish Date | 2018/04 | |
| Author | Toshiki Mimura | Center for Functional Bowel and Anorectal Disorders, Sashiogi Hospital |
| [ Summary ] | In the Japanese guideline for the management of chronic constipation, newly published in 2017, "Constipation" is defined as "A condition, in which a certain amount of stool that ought to be defecated cannot be evacuated sufficiently and comfortably." In this guideline, constipation is first classified into either the "Infrequent Bowel Motion type" or the "Evacuation Difficulty type", solely based on the patient's symptoms and used for their initial case management. If the initial therapies fail, the patient's condition is further classified into normal transit constipation, slow transit constipation, and defecation disorder, utilizing specialized examinations, such as a colonic transit study, defecography, and other methods. The diagnostic criteria for "Chronic Constipation" are a modified version of the Rome IV criteria for "Functional Constipation". Although irritable bowel syndrome (IBS) is excluded from "Functional Constipation" in the Rome IV criteria, IBS can be generally regarded as one of the causes of "Chronic Constipation", and therefore the two conditions of "Insufficient criteria for irritable bowel syndrome" and "Loose stools are rarely present without the use of laxatives" in the Rome IV, were excluded from the diagnostic criteria for "Chronic Constipation" in the Japanese guideline for the management of chronic constipation. |
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