European society of neurogastroenterology and motility guidelines on functional constipation in adults

作者：Jordi Serra, Daniel Pohl, Fernando Azpiroz, Giuseppe Chiarioni, Philippe R. Ducrotte, Guillaume Gourcerol, A. P. S. Hungin, Peter Layer, Juan Manuel Mendive, Johann Pfeifer, Gerhard Rogler, S. Mark Scott, Magnus Simrén, Peter James Whorwell, The Functional Constipation Guidelines Working Group · 发表于：Neurogastroenterology & Motility · 年份：2019 · DOI：10.1111/nmo.13762 · 被引用次数：243 · 研究领域：Gastrointestinal motility and disorders、Congenital gastrointestinal and neural anomalies、Pelvic floor disorders treatments

INTRODUCTION: Chronic constipation is a common disorder with a reported prevalence ranging from 3% to 27% in the general population. Several management strategies, including diagnostic tests, empiric treatments, and specific treatments, have been developed. Our aim was to develop European guidelines for the clinical management of constipation. DESIGN: After a thorough review of the literature by experts in relevant fields, including gastroenterologists, surgeons, general practitioners, radiologists, and experts in gastrointestinal motility testing from various European countries, a Delphi consensus process was used to produce statements and practical algorithms for the management of chronic constipation. KEY RESULTS: Seventy-three final statements were agreed upon after the Delphi process. The level of evidence for most statements was low or very low. A high level of evidence was agreed only for anorectal manometry as a comprehensive evaluation of anorectal function and for treatment with osmotic laxatives, especially polyethylene glycol, the prokinetic drug prucalopride, secretagogues, such as linaclotide and lubiprostone and PAMORAs for the treatment of opioid-induced constipation. However, the level of agreement between the authors was good for most statements (80% or more of the authors). The greatest disagreement was related to the surgical management of constipation. CONCLUSIONS AND INFERENCES: European guidelines on chronic constipation, with recommendations and algori...