Constipation natural history, complications and prognosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Eiman Ghaffarpasand, M.D. [2]


The symptoms of constipation can develop in the different decades of life, and starts with symptoms such as bloating, mucus passage, and abdominal pain. Then the symptoms increase in severity by hardening of stool which is contributes to straining and inability to pass the stool, may be need for manual evacuation. Common complications of chronic constipation include hemorrhoid, anal fissure, fecal impaction, and rectal prolapse. The colonic transit time (CTT) more than 100 hours is associated with a particularly poor prognosis among patients with constipation.

Natural History, Complications, and Prognosis

Natural History



  • Prognosis is generally excellent, and the survival rate of patients with constipation is approximately 100%.
  • The presence of palpable rectal mass and female gender is associated with a good prognosis among patients with constipation.[3]
  • The colonic transit time (CTT) more than 100 hours is associated with a particularly poor prognosis among patients with constipation.[4][5][6]


  1. Choung RS, Locke GR, Rey E, Schleck CD, Baum C, Zinsmeister AR; et al. (2012). "Factors associated with persistent and nonpersistent chronic constipation, over 20 years". Clin Gastroenterol Hepatol. 10 (5): 494–500. doi:10.1016/j.cgh.2011.12.041. PMC 3589972. PMID 22289877.
  2. Cheng M, Ghahremani S, Roth A, Chawla SC (2016). "Chronic Constipation and Its Complications: An Interesting Finding to an Otherwise Commonplace Problem". Glob Pediatr Health. 3: 2333794X16648843. doi:10.1177/2333794X16648843. PMC 4905124. PMID 27336021.
  3. de Lorijn F, van Wijk MP, Reitsma JB, van Ginkel R, Taminiau JA, Benninga MA (2004). "Prognosis of constipation: clinical factors and colonic transit time". Arch Dis Child. 89 (8): 723–7. doi:10.1136/adc.2003.040220. PMC 1720034. PMID 15269069.
  4. Benninga MA, Büller HA, Tytgat GN, Akkermans LM, Bossuyt PM, Taminiau JA (1996). "Colonic transit time in constipated children: does pediatric slow-transit constipation exist?". J. Pediatr. Gastroenterol. Nutr. 23 (3): 241–51. PMID 8890073.
  5. Verduron A, Devroede G, Bouchoucha M, Arhan P, Schang JC, Poisson J, Hémond M, Hébert M (1988). "Megarectum". Dig. Dis. Sci. 33 (9): 1164–74. PMID 3409803.
  6. Benninga MA, Büller HA, Heymans HS, Tytgat GN, Taminiau JA (1994). "Is encopresis always the result of constipation?". Arch. Dis. Child. 71 (3): 186–93. PMC 1029969. PMID 7979489.

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