Asian Neurogastroenterology and Motility Association and Asia-Pacific Association of Gastroenterology Chronic Constipation Consensus 2026.

Background/Aims: : Chronic constipation is a common gastrointestinal (GI) disorder in Asia, characterized by heterogeneous symptom presentation, frequent overlap with other GI symptoms, and limited access to specialized diagnostic tests in many settings. These factors contribute to under-recognition and suboptimal management. The and the APAGE developed a regional consensus to provide practical, evidence-based guidance tailored to the Asian context. Methods: : A multidisciplinary task force comprising 24 voting members and 5 non-voting facilitators from across Asia was convened. Experts were divided into 4 working groups addressing clinical evaluation, non-pharmacological management, pharmacological management, and specialized investigations and treatments. Targeted literature reviews were performed, and statements were developed using a structured Delphi process with iterative anonymous voting. The certainty of the evidence and the strength of the recommendations were graded using the GRADE framework. Results: : Thirty-nine consensus statements were developed, covering clinical assessment and stepwise management. Recommendations emphasize comprehensive symptom assessment, early evaluation of disease severity and psychosocial impact, and prioritizing constipation treatment in patients with overlapping GI symptoms and those with pelvic floor damage. Initial management includes lifestyle modification and conventional laxatives, with treatment response assessed within 4 weeks. For inadequate response, treatment optimization, combination or switching of laxatives, and newer agents are recommended. The algorithm also highlights appropriate use of anorectal physiologic testing and biofeedback therapy for functional defecatory disorders. Surgical interventions are reserved for highly selected patients after comprehensive evaluation. Conclusion: This Asian Neurogastroenterology and Motility Association/Asia-Pacific Association of Gastroenterology consensus provides a practical, algorithm-based framework to improve management of chronic constipation across diverse Asian healthcare settings.

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Publication Details

Journal
PubMed
Published
2026-08-28
DOI
https://doi.org/10.5056/jnm26076
Primary Topic
Gastrointestinal motility and disorders
Type
article
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article

Asian Neurogastroenterology and Motility Association and Asia-Pacific Association of Gastroenterology Chronic Constipation Consensus 2026.

Andrew Ming‐Liang Ong, Sutep Gonlachanvit, Kee Wook Jung, Yeong Yeh Lee et al.
PubMed
Gastrointestinal motility and disorders
article

Asian Neurogastroenterology and Motility Association and Asia-Pacific Association of Gastroenterology Chronic Constipation Consensus 2026.

Andrew Ming‐Liang Ong, Sutep Gonlachanvit, Kee Wook Jung, Yeong Yeh Lee, Tanisa Patcharatrakul, Pakkapon Rattanachaisit, Duc Trong Quach, Panyavee Pitisuttithum, Ari Fahrial Syam, Yi Ping Ren, Linda Zhong, Kewin T H Siah, Kee Huat Chuah, Uday C Ghoshal, Akihito Nagahara, Ching-Liang Lu, Atsushi Nakajima, M Masudur Rahman, Xiucai Fang, Hidekazu Suzuki, Tae Hee Lee, Mariko Hojo, Ying-Lian Xiao, Xiaohua Hou, Justin C Y Wu, Sabrina Quek, Chien-Lin Chen, Govind K Makharia, Tao Bai
article en

Abstract

Background/Aims: : Chronic constipation is a common gastrointestinal (GI) disorder in Asia, characterized by heterogeneous symptom presentation, frequent overlap with other GI symptoms, and limited access to specialized diagnostic tests in many settings. These factors contribute to under-recognition and suboptimal management. The and the APAGE developed a regional consensus to provide practical, evidence-based guidance tailored to the Asian context. Methods: : A multidisciplinary task force comprising 24 voting members and 5 non-voting facilitators from across Asia was convened. Experts were divided into 4 working groups addressing clinical evaluation, non-pharmacological management, pharmacological management, and specialized investigations and treatments. Targeted literature reviews were performed, and statements were developed using a structured Delphi process with iterative anonymous voting. The certainty of the evidence and the strength of the recommendations were graded using the GRADE framework. Results: : Thirty-nine consensus statements were developed, covering clinical assessment and stepwise management. Recommendations emphasize comprehensive symptom assessment, early evaluation of disease severity and psychosocial impact, and prioritizing constipation treatment in patients with overlapping GI symptoms and those with pelvic floor damage. Initial management includes lifestyle modification and conventional laxatives, with treatment response assessed within 4 weeks. For inadequate response, treatment optimization, combination or switching of laxatives, and newer agents are recommended. The algorithm also highlights appropriate use of anorectal physiologic testing and biofeedback therapy for functional defecatory disorders. Surgical interventions are reserved for highly selected patients after comprehensive evaluation. Conclusion: This Asian Neurogastroenterology and Motility Association/Asia-Pacific Association of Gastroenterology consensus provides a practical, algorithm-based framework to improve management of chronic constipation across diverse Asian healthcare settings.

PubMed
Ulsan College (KR), Thai Red Cross Society (TH), Tokai University (JP), Union Hospital (HK), Apollo Hospitals (IN), National Yang Ming Chiao Tung University (TW), Sun Yat-sen University (CN), Chulalongkorn University (TH), National University of Singapore (SG), Nanyang Technological University (SG), Chinese University of Hong Kong (HK), Tzu Chi University (TW), Chinese Academy of Medical Sciences & Peking Union Medical College (CN), Singapore General Hospital (SG), Bumrungrad International Hospital (TH), Peking Union Medical College Hospital (CN), Soonchunhyang University Hospital Seoul (KR), Asan Medical Center (KR), King Chulalongkorn Memorial Hospital (TH), University of Medicine and Pharmacy at Ho Chi Minh City (VN), Taipei Veterans General Hospital (TW), University of Indonesia (ID), University of Malaya (MY), Juntendo University (JP), Gono University (BD), University of Ulsan (KR), Hospital Universiti Sains Malaysia (MY), Apollo Hospitals (IN), International University Of Health And Welfare Atami Hospital (JP), National University Hospital (SG), Pham Ngoc Thach Hospital (VN), Bệnh viện Nhân dân Gia Định (VN), Huazhong University of Science and Technology (CN), All India Institute of Medical Sciences (IN)
Good health and well-being
Openalex Percentile: Top 9%
Gastrointestinal motility and disorders
DOISourceOpenAlex
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