Research Progress in Clinical Study of Chronic Constipation

Abstract

Chronic constipation is a global functional gastrointestinal disorder with a prevalence of approximately 10% to 15%, significantly impacting patients’ quality of life and imposing a substantial economic burden. In the past five years (2019-2024), significant progress has been made in this field regarding epidemiology, pathophysiology, diagnostic criteria, and treatment strategies. This article systematically reviews the research progress on chronic constipation using a four-dimensional analytical framework: “epidemiological characteristics—pathophysiological mechanisms—evolution of diagnostic criteria—comparison of treatment strategies. “ In terms of epidemiology, new evidence has emerged regarding the dose-response relationship between dietary carotenoid and micronutrient intake and the risk of constipation. Regarding pathological mechanisms, research on the dysregulation of the gut microbiota-motility axis and the brain-gut axis has revealed multi-level progressive pathogenic mechanisms. In diagnosis, the promotion of Rome IV criteria and the application of novel bedside assessment tools such as portable ultrasound have driven the standardization of diagnostic processes. In treatment, new drugs such as prokinetics, secretagogues, and bile acid transporter inhibitors, along with non-pharmacological interventions like probiotics, biofeedback, and fecal microbiota transplantation, form a complementary treatment landscape. However, the strength of evidence varies across dimensions, and the translation from mechanisms to clinical practice remains a bottleneck. Precise subtyping and comprehensive intervention are the core directions for the future.