Taking a Load Off Diagnosing Constipation: Utility of the Plain Film

Excerpt

Constipation is a common complaint of patients cared for in gastroenterology and primary care clinics. Functional constipation, diagnosed clinically, is often associated with diagnostic uncertainty, since patients frequently describe alternating constipation and diarrhea. Indeed, fluctuating bowel habits led to many irritable bowel syndrome (IBS) patients being subtyped as IBS-U (rather than IBS-C, IBS-D, or IBS-M) under the previously utilized Rome III diagnostic criteria [1]. This difficulty in making a clinical diagnosis of constipation can lead to challenges in determining appropriate medical management, for example, a mixture of constipation and diarrhea symptoms could represent either constipation with overflow diarrhea or the mixed subtype of irritable bowel syndrome. A laxative may be helpful for both symptoms in the former case, but may worsen underlying diarrhea in the latter case. …