Fig. 3. Diagnostic approach of functional constipation. (A) Diagnostic algorithm in specialized centers where anorectal manometry (ARM) can be available. (B) A possible diagnostic algorithm in medical institutions where ARM cannot be available. *Defecography could be performed concurrently with ARM when it is feasible or when structural abnormalities of the pelvic floor are clinically suspected. **Consider chronic constipation due to other causes such as drug, underlying disease, or IBS-C, etc. ***Apply the diagnostic algorithm in
Figure 3A. BET, balloon expulsion test; CTT, colon transit time; STC, slow transit constipation; RSCTT, rectosigmoid CTT; FDD, functional defecation disorder; MDT, multidisciplinary team.
