00235 Chronic Functional Constipation

Domain 3: elimination and exchange
Class 2: gastrointestinal function
Diagnostic Code: 00235
Nanda label: chronic functional constipation
Diagnostic focus: functional constipation
Approved 2013 • Revised 2017 • Evidence level 2.2

NANDA Nursing Diagnosis Definition

Nanda nursing diagnosis « chronic functional constipation ” is defined as: infrequent or difficult evacuation, maintained at least for three of the previous twelve months.

Definite characteristics

GENERAL

  • Abdominal distension
  • Fecal impact
  • Stool escape with digital stimulation
  • defecation pain
  • Palpable abdominal mass
  • positive blood test in feces
  • Prolonged effort
  • Type 1 or 2 on the Bristol Stool Scale

Adult: Presence of ? 2 of the following symptoms in the Roma III classification system:

  • lumpy or hard feces in ? 25 % of defecations
  • Manual maneuvers to facilitate ? 25 % of defecations (digital manipulation, pelvic soil support)
  • Sensation of obstruction/anorectal block in ? 25 % of defecations
  • Incomplete evacuation sensation in ? 25 % of defecations
  • Effort for ? 25 % of defecations
  • ? 3 weekly evacuations

Child> 4 years: Presence of ? 2 of the following criteria in the Roma III Pediatric classification system for ? 2 months:

  • Great diameter of the feces that can obstruct the toilet
  • Hard or painful evacuations
  • Presence of large fecal masses in the rectum
  • Fecal retention posture
  • <2 weekly defecations
  • ? 1 episode of weekly fecal incontinence

Child ? 4 years: presence of ? 2 of the following criteria in the Roma III Pediatric classification system for ? 1 month:

  • Great diameter of the feces that can obstruct the toilet
  • Hard or painful evacuations
  • Presence of large fecal masses in the rectum
  • Fecal retention posture
  • <2 weekly defecations
  • ? 1 episode of weekly fecal incontinence

Related factors

  • Decrease in food intake
  • Dehydration
  • Diet disproportionately high in fats
  • Diet disproportionately high in protein
  • Elder’s fragility syndrome
  • It usually represses the urgency to defecate
  • deterioration of physical mobility
  • Inadequate intake dietary habits
  • Insufficient knowledge of modifiable factors
  • Insufficient fiber intake
  • Insufficient fluid intake
  • Low caloric intake
  • Sedentary lifestyle

Risk population

  • Older adults
  • Pregnant women

Associated problems

  • amyloidosis
  • Anal fissure
  • Anal stenosis
  • Autonomic neuropathy
  • Intestinal chronic pseudoobstructure
  • Chronic renal failure
  • Colorectal cancer
  • Depression
  • Dermatomyositis
  • Diabetes mellitus
  • Extractinal mass
  • Hemorrhoids
  • Hirschsprung disease
  • Hypercalcemia
  • Hypothyroidism
  • Inflammatory bowel disease
  • Ischemic stenosis
  • Multiple sclerosis
  • Myotonic dystrophy
  • Neurocognitive disorder
  • PanHipopituitarism
  • Paraplegia
  • Parkinson’s disease
  • Pelvic floor disorders
  • Perineal injury
  • Pharmacological preparations
  • Polymedication
  • Porfiria
  • Postinflamatory stenosis
  • Proctitis
  • Sclerodermia
  • Slow transit of the colon
  • Spinal cord injuries
  • stroke
  • Surgical stenosis