What is the role of onset of symptoms and duration of the problem in the diagnosis of constipation?

Updated: Jul 05, 2019
  • Author: Marc D Basson, MD, PhD, MBA, FACS; Chief Editor: BS Anand, MD  more...
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Answer

The duration of the problem is important. In adolescents and young adults, the duration of the problem may differentiate congenital defects from acquired causes. Neoplastic obstruction is less likely in younger patients or in patients older than 50 years who have had symptoms for at least 2 years and/or have recently had a screening colonoscopy. However, colon cancer certainly occurs in younger adults and even rarely in teenagers, while a previous screening colonoscopy may have missed a neoplasm.

The onset of symptoms is also very important, in that intestinal obstruction can present as acute constipation. In the hospital setting, ileus from another illness or Ogilvie syndrome should also be considered. Questions regarding the onset of constipation may provide useful etiologic information, whether in terms of changes in diet, new medications, or associated psychosocial difficulties at that time.


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