title: [Clinical practice guidelines: Irritable bowel syndrome with constipation and functional constipation in adults: Concept, diagnosis, and healthcare continuity. (Part 1 of 2)].
abstract: In this Clinical practice guide, an analysis is made of the diagnosis and treatment of adult patients with constipation and abdominal discomfort, under the spectrum of irritable bowel syndrome and functional constipation. These have an important personal, health and social impact, affecting the quality of life of these patients. In irritable bowel syndrome with a predominance of constipation, this is the predominant change in bowel movements, with recurrent abdominal pain, bloating and frequent abdominal distension. Constipation is characterised by infrequent or difficulty in bowel movements, associated with excessive straining during bowel movement or sensation of incomplete evacuation. There is often no underling cause, with an intestinal functional disorder being considered. They have many clinical and pathophysiological similarities, with a similar response of the constipation to common drugs. The fundamental difference is the presence or absence of pain, but not in a way evaluable way; "all or nothing". The severity depends on the intensity of bowel symptoms and other factors, a combination of gastrointestinal and extra-intestinal symptoms, level of involvement, forms of perception, and behaviour. The Rome criteria diagnose functional bowel disorders. This guide is adapted to the Rome criteria IV (May 2016) and in this first part an analysis is made of the alarm criteria, diagnostic tests, and the criteria for referral between Primary Care and Digestive Disease specialists. In the second part, a review will be made of the therapeutic alternatives available (exercise, diet, drug therapies, neurostimulation of sacral roots, or surgery), making practical recommendations for each one of them.
authors.affiliation: Coordinación de la guía de práctica clínica (GPC), Comité Roma de Trastornos Funcionales Intestinales, Asociación Española de Gastroenterología (AEG), Centro Médico Teknon, Barcelona, España.
authors.forename: F
authors.initials: F
authors.lastname: Mearin
authors.affiliation: Grupo de Trastornos Funcionales, Sociedad Española de Patología Digestiva (SEPD), Hospital Universitario Doce de Octubre, Madrid, España.
authors.forename: C
authors.initials: C
authors.lastname: Ciriza
authors.affiliation: AEG y SEPD, Hospital Clínico Universitario, Universitat de Valencia, Valencia, España.
authors.forename: M
authors.initials: M
authors.lastname: Mínguez
authors.affiliation: SEPD Hospital Clínico Universitario San Carlos, Madrid, España.
authors.forename: E
authors.initials: E
authors.lastname: Rey
authors.affiliation: Secretaría Científica, Sociedad Española de Medicina de Familia y Comunitaria (semFYC), España. Electronic address: jmascort@semfyc.es.
authors.forename: J J
authors.initials: JJ
authors.lastname: Mascort
authors.affiliation: Coordinación de Digestivo, Sociedad Española de Médicos de Atención Primaria (SEMERGEN), España.
authors.forename: E
authors.initials: E
authors.lastname: Peña
authors.affiliation: Coordinación de Digestivo, Sociedad Española de Médicos Generales y de Familia (SEMG), España.
authors.forename: P
authors.initials: P
authors.lastname: Cañones
authors.affiliation: Departamento de Gestión del Conocimiento, SEPD, España.
authors.forename: J
authors.initials: J
authors.lastname: Júdez
mesh_terms: D000328:Adult; D000465:Algorithms; D003248:Constipation / Q000150:complications / Q000175:diagnosis* / Q000628:therapy*; D003266:Continuity of Patient Care; D006801:Humans; D043183:Irritable Bowel Syndrome / Q000150:complications / Q000175:diagnosis* / Q000628:therapy*
keywords: Abdominal discomfort; Adultos; Adults; Atención Primaria; Clinical practice guide; Digestive Diseases; Enfermedades digestivas; Estreñimiento funcional; Functional constipation; Guía de práctica clínica; Irritable bowel syndrome; Molestia abdominal; Primary Care; Roma IV; Rome IV; Síndrome del intestino irritable