Describe the complication management.
Identify and treat fecal impaction.
Suspected acute complication (e.g., bowel obstruction, bowel perforation) [14]
Urgent general surgery and/or gastroenterology consult
Obtain urgent abdominal imaging (CT or x-ray abdomen).
Describe the rest of management approach.
Perform a clinical evaluation for constipation, including identification of:
Red flags in adults with constipation
Rome IV diagnostic criteria for primary constipation in adults
Risk factors for primary constipation
Clinical features or history (including medication history) suggestive of a secondary cause of constipation
No abnormal findings, no red flags
Obtain a CBC to evaluate for anemia; other laboratory tests and imaging are not routinely recommended.
Diagnose functional constipation if Rome IV diagnostic criteria for primary constipation in adults are met.
Abnormal findings or red flags
Red flags in constipation: colonoscopy to evaluate for colorectal malignancy
Suspected secondary constipation: Identify and treat the underlying cause.
Obtain laboratory studies as needed.
Acute-onset constipation associated with abdominal pain should raise suspicion for possible bowel obstruction. Complete bowel obstruction is a medical emergency.
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