Functional constipation

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Mugilan Poongkunran M.B.B.S [2]

Overview

Functional constipation is a form of constipation with a psychological or psychosomatic background. A person suffering from it is physiologically healthy, but still experiences trouble defecating. Functional constipation is medically defined by the Rome III criteria.

Rome III Criteria for Functional Constipation

Any 2 of the following
Less than three evacuations per week
Lumpy or hard stools in ≥ 25% of defecations
Straining during ≥ 25% of defecations
Anorectal obstruction sensation for ≥ 25% of defecations
Manual maneuvers to facilitate ≥ 25% of defecations
Incomplete evacuation sensation for ≥ 25% of defecations
Loose stools are not present
Insufficient criteria for irritable bowel syndrome

† Criteria fulfilled for the past 3 months and symptom onset at least 6 months before diagnosis.[1]

American Gastroenterological Association, however have stopped using the term functional constipation because a subset these patients have slow colonic transit that has been associated with a marked reduction in colonic intrinsic nerves and interstitial cells of Cajal which is against the true definition of functional disorder.[2]

Causes

Functional constipation has many causes, some of which are:

  • a bad diet
  • an unwillingness to defecate
  • nervous reactions, including prolonged and/or chronic stress and anxiety, that close the inner anal sphincter muscle, which isn't under voluntary control
  • inability or unwillingness to control one's outer anal sphincter, which is normally under voluntary control
  • deeper psychosomatic disorders which sometimes affect digestion and the absorption of water in the colon

References

  1. Longstreth GF, Thompson WG, Chey WD, Houghton LA, Mearin F, Spiller RC (2006). "Functional bowel disorders". Gastroenterology. 130 (5): 1480–91. doi:10.1053/j.gastro.2005.11.061. PMID 16678561.
  2. Farrugia G (2008). "Interstitial cells of Cajal in health and disease". Neurogastroenterol Motil. 20 Suppl 1: 54–63. doi:10.1111/j.1365-2982.2008.01109.x. PMID 18402642.

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