Find information on Chronic Constipation (C), including clinical documentation, medical coding, and healthcare resources. Learn about Functional Constipation and Idiopathic Constipation, common alternate names for this condition. This resource provides guidance on diagnosis, treatment, and management of Chronic Constipation for healthcare professionals.
Also known as
Constipation
Functional constipation, slow transit, or outlet dysfunction.
Constipation, unspecified
Constipation without further specification.
Slow transit constipation
Delayed passage of stool through the colon.
Other constipation
Constipation not otherwise specified, including functional.
Follow this step-by-step guide to choose the correct ICD-10 code.
Is the constipation opioid-induced?
Yes
Code as K59.0, Constipation due to opioids
No
Is the constipation due to another specific cause?
When to use each related code
| Description |
|---|
| Infrequent bowel movements, difficulty passing stool. |
| Pelvic floor dysfunction causing obstructed defecation. |
| Constipation due to opioid use. |
Coding chronic constipation without specifying functional or idiopathic type may lead to underpayment. Impacts CDI and HCC coding.
Failing to code associated conditions like irritable bowel syndrome or pelvic floor dysfunction impacts quality and reimbursement.
Insufficient documentation of symptom duration, frequency, and severity for chronic constipation creates audit risk and coding inaccuracies.
Q: What are the most effective evidence-based treatments for chronic constipation in adult patients, differentiating between functional and idiopathic subtypes?
A: Managing chronic constipation effectively requires distinguishing between functional constipation (FC) and idiopathic constipation. FC is diagnosed based on Rome IV criteria, focusing on symptom duration and characteristics like straining, lumpy or hard stools, and incomplete evacuation. Idiopathic constipation, on the other hand, lacks an identifiable cause after excluding secondary causes like metabolic disorders, medications, and anatomical abnormalities. Evidence-based treatments for both subtypes often overlap, emphasizing lifestyle modifications such as increased fluid intake and dietary fiber, particularly soluble fiber. For FC, incorporating exercise and pelvic floor retraining can be beneficial. Pharmacological interventions, like osmotic laxatives (e.g., polyethylene glycol) and stimulant laxatives (e.g., bisacodyl), can be used judiciously, with the choice depending on individual patient needs and response. For refractory cases of idiopathic constipation, further investigations may be warranted to rule out underlying neuromuscular disorders or other less common causes. Consider implementing a stepped-care approach, starting with conservative measures and escalating as needed based on patient response and tolerance. Explore how incorporating biofeedback therapy can enhance pelvic floor retraining for functional constipation. Learn more about the Rome IV diagnostic criteria for functional constipation to ensure accurate diagnosis and targeted treatment.
Q: How can clinicians differentiate chronic constipation from opioid-induced constipation (OIC) in patients receiving chronic opioid therapy, and what are the preferred management strategies for each?
A: Differentiating chronic constipation from opioid-induced constipation (OIC) requires a thorough patient history, including medication review and assessment of bowel habits before opioid initiation. While both conditions share symptoms like infrequent bowel movements and straining, OIC typically develops after starting opioid therapy and improves with opioid discontinuation or dose reduction, if feasible. Clinicians should carefully evaluate for other contributing factors to constipation, such as dehydration, low fiber intake, and immobility. Management of OIC differs significantly from managing primary chronic constipation. For OIC, the first step is reviewing the necessity and dose of the opioid medication. Peripheral mu-opioid receptor antagonists (PAMORAs), such as naloxegol and methylnaltrexone, are specifically indicated for OIC and can effectively relieve symptoms without impacting central opioid analgesia. Stimulant laxatives can be added, but osmotic laxatives may be preferred to avoid excessive straining. For chronic constipation unrelated to opioids, lifestyle modifications and other laxative options, as outlined in evidence-based guidelines, should be considered. Explore how incorporating PAMORAs can optimize OIC management in palliative care settings. Learn more about the latest clinical guidelines for managing OIC to stay updated on best practices.
Patient presents with complaints consistent with chronic constipation, also known as functional constipation or idiopathic constipation. The patient reports infrequent bowel movements, typically less than three per week, and describes straining, hard stools, and a sensation of incomplete evacuation. Symptoms have persisted for over six months and meet Rome IV criteria for functional constipation. The patient denies any identifiable secondary cause such as medication use (e.g., opioids, anticholinergics), metabolic disorders (e.g., hypothyroidism, diabetes), or neurological conditions. Abdominal examination reveals mild distension and no palpable masses. Digital rectal examination reveals normal sphincter tone and no evidence of fecal impaction. Differential diagnosis includes irritable bowel syndrome with constipation predominance (IBS-C) and slow transit constipation. Initial management will focus on conservative measures, including increased dietary fiber intake, increased fluid intake, and regular exercise. Patient education regarding bowel habits and toileting techniques was provided. A trial of over-the-counter osmotic laxatives such as polyethylene glycol (PEG) will be initiated. Follow-up scheduled in two weeks to assess response to treatment and consider further investigations if necessary, including colonoscopy or anorectal manometry if symptoms do not improve. ICD-10 code K59.04 (Chronic constipation unspecified) is assigned.