Constipation – colloquially called constipation – (synonyms: constipation; coprostasis; obstructio alvi; retentio alvi; constipation; ICD-10-GM K59.0-: Constipation) refers to difficult, infrequent, or incomplete defecation (bowel movements). It is defined as low stool frequency with fewer than 3 bowel movements per week. Normal stool frequency varies from 3 bowel movements per day to 3 per week in healthy individuals. Finding exact boundaries between normal stool frequency and constipation is usually very difficult. However, most people have bowel movements at least three times a week. In addition to the frequency of the stool, its texture is also important. If the stool is too firm, for example, hemorrhoids can develop as a result of pressing too hard.
In about 90 % of those affected, no explanatory cause can be found. And even in sufferers with severe constipation, the cause is only identified in 30% of cases.
Constipation is classified according to several aspects:
- Acute and chronic constipation (constipation persists for more than three months).
- Cologenic (affecting the large intestine) and anorectal (affecting the rectum and anus) constipation – describes the section of the intestine causing the constipation
- Primary (functional) versus secondary constipation – in primary constipation, in contrast to secondary constipation, no cause can be determined
Primary (functional) constipation is characterized using Rome IIV criteria – see constipation/classification for details.
Sex ratio: males to females is 1: 2.
Frequency peak: the disease occurs predominantly with increasing age.
The prevalence (disease incidence) is 20-30 % in the group of people over 60 years of age (in Germany). 15% of women and 5% of men are affected in the long term in Germany. Hard stools, incomplete defecation, abdominal discomfort improving with defecation, or a distended abdomen are reported by about 10-30% of the population. A stool frequency < 3 bowel movements/week is observed in about 4%, and less than 2 bowel movements/week in 1-2% of the population. Constipation is less common in Africa.
Course and prognosis: The course of the disease depends on the cause. If constipation is diet-related, rapid improvement can be achieved by simple measures such as a high-fiber diet, adequate fluid intake, and physical activity. Pharmacotherapy (e.g., the use of laxatives) should be used only after consultation with the treating physician.
