Guidelines for the Diagnosis and Treatment of Chronic Functional Constipation in Korea, 2015 Revised Edition

Abstract

The Korean Society of Neurogastroenterology and Motility first published guidelines for chronic constipation in 2005 and was updated in 2011. Although the guidelines were updated using evidence-based process, they lacked multidisciplinary participation and did not include a diagnostic approach for chronic constipation. This article includes guidelines for diagnosis and treatment of chronic constipation to realistically fit the situation in Korea and to be applicable to clinical practice. The guideline development was based upon the adaptation method because research evidence was limited in Korea, and an organized multidisciplinary group carried out systematical literature review and series of evidence-based evaluations. Six guidelines were selected using the Appraisal of Guidelines for Research & Evaluation (AGREE) II process. A total 37 recommendations were adopted, including 4 concerning the definition and risk factors of chronic constipation, 8 regarding diagnoses, and 25 regarding treatments. The guidelines are intended to help primary physicians and general health professionals in clinical practice in Korea, to provide the principles of medical treatment to medical students, residents, and other healthcare professionals, and to help patients for choosing medical services based on the information. These guidelines will be updated and revised periodically to reflect new diagnostic and therapeutic methods.

Keywords: Adaptation; Constipation; Diagnosis; Guideline; Treatment.

Figure 1

Flowchart of study selection.

Figure 2

Appraisal results of candidate guidelines by the Appraisal of Guidelines for Research & Evaluation (AGREE) II. Selected guidelines number: 1, Canadian recommendation; 2, Korean guideline; 3, Italian consensus for diagnosis; 4, Italian consensus for treatment; 5, American Gastroen-terological Association medical position statement on constipation; and 6, American Gastroenterological Association technical review on constipation.

Figure 3

The Bristol Stool Form Scale.