| Abstract [eng] |
Introduction. Chronic constipation is one of the most common gastrointestinal disorders and has a significant impact on patients’ quality of life as well as healthcare resource utilization. In recent years, it has become increasingly clear that this condition should not be viewed as a simple symptom but rather as a complex disorder involving multiple mechanisms, including altered gut motility, neural regulation, and interactions with the gut microbiota. Aim. To summarize current evidence on the epidemiology, pathophysiology, diagnosis, and management of chronic constipation, with a focus on cause and its relevance to everyday clinical practice. Methods. This review is based on recent scientific literature, including review articles, clinical studies, and international guidelines, with particular emphasis on publications from 2018 onwards. Results. The prevalence of chronic constipation in the general population is estimated at 10–20%, with higher rates observed in older individuals. The condition is heterogeneous, encompassing different underlying mechanisms that require a tailored diagnostic and therapeutic approach. Diagnosis is primarily clinical, with further investigations reserved for selected patients. Management includes lifestyle modifications, pharmacological treatment, and, in selected cases, surgical intervention. Recent evidence highlights substantial variability in treatment response. Conclusions. Polyethylene glycol remains first-line therapy, but early escalation is required in patients with insufficient response. In defecatory disorders, laxatives are often ineffective, making targeted diagnostics such as anorectal manometry essential. Prolonged use of ineffective treatment should be avoided. Given the high rate of persistent or recurrent symptoms, long-term follow-up and individualized management are necessary. |
