Errores frecuentes en el diagnóstico del estreñimiento crónico del adultoCasos clínicos

Laburpena

Chronic constipation in adults is a very frequent pathology, with a prevalence of up to 24% in the general population, which reaches up to 80% in the elderly population. It is defined according to the number of bowel movements, the difficulty to defecate and/or the change in the consistency of bowel movements. In addition, there is another series of accompanying symptoms that must be taken into account such as abdominal pain, distension, incomplete evacuation sensation, etc. Constipation is classified according to its etiology in primary, by alteration of the colonic or anorectal function, and secondary, by own diseases of the colon, metabolic or neurological alterations, or as a consequence of the use of certain drugs. To make an adequate diagnosis of chronic constipation, it is essential to make a good anamnesis, know how to identify the alarm criteria and make an adequate physical examination, both abdominal and anorectal. This way, we will avoid carrying out complementary tests in an unjustified way, which will be reserved for cases in which there are alarm symptoms or are in the range of population screening for colorectal cancer. Functional tests such as anorectal manometry, balloon expulsion test, defecography and colonic transit will allow us to make a pathophysiological approach to the problem and will be reserved for a second diagnostic step.