Pre-Operative Diagnostics of Colonic and Rectal Dysfunction

Background  Chronic functional constipation like slow transit constipation (STC) summarises a group of health conditions affecting an increasing number of people due to demographical developments of the Western world. Chronic functional constipation can be identified through the Rome IV criteria and does not show any structural causes for the symptoms. Due to the complexity and individuality of the clinical picture, a systematic approach towards finding the correct diagnosis and treatment is necessary for providing a structured, cost-efficient diagnostic pathway to the patient and the physician.

Methods  Observation of clinical routine and comparison of diagnostic tools and pathways regarding chronic functional constipation with a focus on slow transit constipation were conducted and critically reviewed using literature and guidelines. 44 publications were selected for the establishment of a clinically relevant and easy-to-access flowchart.

Results  A systematic approach regarding the symptoms at initial presentation, intermediate therapeutic outcomes and the need of surgery was made. Economic cost of examinations and imaging techniques was taken into consideration. A flowchart was created in order to summarise the findings for daily use in clinical practice and ultimately deciding the adequate indication for surgical repair.

Conclusion  Finding a correct step-by-step pathway through the diagnostic process of chronic functional constipation is necessary for assuring quality of care. The flowchart takes the occurrence of gastrointestinal warning signs into consideration and leads the physician through a sensible and useful proceeding of diagnostics. Through that, the care for patients with chronic functional constipation is respectfully taking its place in modern visceral medicine.

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Artikel online veröffentlicht:
24. Mai 2023