How are acute and chronic constipation distinguished, and why does the distinction matter?

Clinical relevance. Treating acute new-onset constipation as a red flag for mechanical obstruction prevents missing colorectal cancer.

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Acute versus chronic constipation

The duration of constipation guides the urgency and direction of investigation in adults.

Acute constipation (under 3 months)

• Always think of a mechanical cause: colonic stricture, neoplasm, or faecal impaction.
• New-onset constipation, especially over the age of 40, warrants investigation to exclude colorectal cancer.

Chronic constipation (over 3 months)

• Usually functional; classified into slow-transit or obstructed-defaecation type.

Why it matters

• Acute change in bowel habit may signal serious organic disease, whereas chronic functional constipation is managed differently (lifestyle, laxatives, biofeedback).