AGA Issues Updated Constipation Guideline
Symptoms of constipation are extremely common; the prevalence is approximately 16 percent in adults overall and 33 percent in adults older than 60 years. To assist gastroenterologists who care for patients with constipation, the AGA published a new guideline in the January issue of Gastroenterology.
Although the overall classification of chronic constipation into three categories (ie, normal transit, isolated slow transit and defecatory disorders) and several recommendations in this new guideline are similar to the prior version, there are three substantive changes.
1. These guidelines recommend assessment of colonic transit at a later stage, that is, only for patients who do not have a defecatory disorder or patients with a defecatory disorder that has not responded to pelvic floor retraining.
2. The evidence supporting these recommendations has been evaluated using the GRADE system, in which the strength of recommendation is rated as strong or weak and the quality of evidence is rated as high, moderate, low or very low.
3. Therapeutic recommendations have been updated to include newer agents and delete certain older agents.