Emergency department diagnosis and management of constipation in the United States, 2006–2017

Amy Z. Zhou, Douglas Lorenz, Norma Jean Simon, Todd A. Florin

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Constipation is a common diagnosis in adults and children. Emergency department (ED) visits for constipation increased from 1980 to 2010. Since then, efforts have aimed to reduce resource utilization for constipation in the ED setting. Our objective is to examine contemporary ED practice patterns in the context of updated care guidelines. Methods: We conducted a cross-sectional study using the National Hospital Ambulatory Medical Care Survey from 2006 to 2017. Encounters with a constipation diagnosis were included. We examined rates of ED visits, diagnostic testing, and medication use. We also compared general and pediatric ED practice patterns for children. Results: Approximately 1.3 million ED visits with a diagnosis of constipation occurred annually, with pediatric encounters comprising one-third of all visits. There was a 114% increase in ED visits for constipation over the study period. Urinalysis and imaging increased by 17% and 15%, respectively. Older patients were more likely to undergo diagnostic testing. No significant changes in laboratory testing, radiographs, or osmotic laxative prescriptions were observed among children. Compared to pediatric EDs, general EDs were more likely to perform CBC (29% vs. 15%) and urinalysis testing (42% vs 31%). General EDs were less likely to prescribe osmotic laxatives for children compared to pediatric EDs (26% vs. 37%). Conclusion: ED visits for constipation have increased significantly since 2006. Rates of diagnostic tests and prescriptions have not changed despite published evidence and guidelines that the diagnosis of constipation does not require imaging, and that the management of constipation requires consistent outpatient treatment. Opportunities exist to reduce ED resource utilization through knowledge dissemination and implementation.

Original languageEnglish (US)
Pages (from-to)91-96
Number of pages6
JournalAmerican Journal of Emergency Medicine
Volume54
DOIs
StatePublished - Apr 2022
Externally publishedYes

Keywords

  • Constipation
  • Diagnostic testing
  • Emergency department
  • Resource utilization

ASJC Scopus subject areas

  • Emergency Medicine

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