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Background <p>Chronic constipation is one of the most common reasons for gastroenterological consultation and affects women twice as frequently as men. Its definition varies between clinical Rome&#xa0;V criteria and patient perception. The three pathophysiological subtypes—normal-transit constipation (NTO), slow-transit constipation (STO), and dyssynergic defecation (DD)—frequently overlap with each other and with secondary forms, complicating both diagnosis and treatment. A&#xa0;standardized, subtype-oriented approach is therefore required.</p> Objective <p>Practice-oriented, evidence-based overview of the diagnosis and stepwise management of chronic constipation, incorporating current guidelines and medications approved in Europe.</p> Materials and methods <p>Narrative review based on international guidelines (Rome&#xa0;V, World Gastroenterology Organisation [WGO] 2025, American Gastroenterological Association [AAGA]/American College of Gastroenterology [ACG] 2023, Société Nationale Française de Colo-Proctologie [SNFCP] 2017, Deutsche Gesellschaft für Verdauungs- und Stoffwechselkrankheiten [DGVS] S2k 2022), systematic reviews, and meta-analyses.</p> Results <p>Clinical evaluation, anorectal function testing, and colonic transit time measurement enable subtype classification. Treatment follows a&#xa0;stepwise approach: fiber supplementation as first-line therapy, followed by osmotic laxatives, stimulant laxatives, and prucalopride or linaclotide. Biofeedback (BFB) is the treatment of choice for dyssynergic defecation. Surgical options remain reserved for strictly selected patients.</p> Conclusion <p>Subtype classification enables targeted therapy.</p>

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Chronische Obstipation und obstruktives Defäkationssyndrom

  • 期刊论文

  • 发表日期：

    2026年6月3日

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  • Aurora Maria Tatu

摘要

Background

Chronic constipation is one of the most common reasons for gastroenterological consultation and affects women twice as frequently as men. Its definition varies between clinical Rome V criteria and patient perception. The three pathophysiological subtypes—normal-transit constipation (NTO), slow-transit constipation (STO), and dyssynergic defecation (DD)—frequently overlap with each other and with secondary forms, complicating both diagnosis and treatment. A standardized, subtype-oriented approach is therefore required.

Objective

Practice-oriented, evidence-based overview of the diagnosis and stepwise management of chronic constipation, incorporating current guidelines and medications approved in Europe.

Materials and methods

Narrative review based on international guidelines (Rome V, World Gastroenterology Organisation [WGO] 2025, American Gastroenterological Association [AAGA]/American College of Gastroenterology [ACG] 2023, Société Nationale Française de Colo-Proctologie [SNFCP] 2017, Deutsche Gesellschaft für Verdauungs- und Stoffwechselkrankheiten [DGVS] S2k 2022), systematic reviews, and meta-analyses.

Results

Clinical evaluation, anorectal function testing, and colonic transit time measurement enable subtype classification. Treatment follows a stepwise approach: fiber supplementation as first-line therapy, followed by osmotic laxatives, stimulant laxatives, and prucalopride or linaclotide. Biofeedback (BFB) is the treatment of choice for dyssynergic defecation. Surgical options remain reserved for strictly selected patients.

Conclusion

Subtype classification enables targeted therapy.