There are a number of common gastrointestinal conditions, disorders and diseases that may cause problems. These include:


Constipation is a common complaint and can have a significant impact on quality of life, particularly if it is severe. Constipation may have a variety of causes (including slow colonic transit, ano-rectal dysfunction, systemic disorders and drugs) and usually responds to a combination of dietary modification, use of laxatives, purgatives or enemas and more specialised medication. Investigations that are sometimes performed as part of the assessment include colonoscopy, colonic transit studies (e.g. using the Smartpill), breath testing, ano-rectal manometry and a defecating proctogram.

The diagnosis of constipation is based on the presence of the following for at least 3 months (with symptom onset at least 6 months prior to diagnosis):

1. Must include 2 or more of the following:

  • Straining for at least 25% of defecations
  • Lumpy or hard stools in at least 25% of defecations
  • Sensation of incomplete evacuation for at least 25% of defecations
  • Sensation of ano-rectal obstruction/blockage for at least 25% of defecations
  • Manual maneuvers to facilitate at least 25% of defecations (for example digital evacuation, support of the pelvic floor)
  • Fewer than 3 defecations per week

2. Loose stools that are rarely present without the use of laxatives

3. Symptoms not compatible with a diagnosis of IBS.


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