ABSTRACT

There are major problems in defining constipation. The variety of definitions amongst studies, is a large issue. The literature shows that physicians and patients define constipation differently. “Unsatisfactory defecation with stool retention” is a definition that appears to be well understood by patients and meets the opinion of the physicians. In discussing defecation with patients, “satisfaction” is a single subjective item that includes the patient’s perception both in slow transit and outlet obstruction. It recalls the quality of life and it seems preferable to any choice of items that can be found in the various scoring systems. The quantification of the symptoms by scoring all the items is essential for defining the severity of the condition. The Integral Theory System gives further light to the pathophysiology of defecation.