{ "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 Asian Neurogastroenterology and Motility Association (ANMA) and the Asia-Pacific Association of Gastroenterology (APAGE) developed a regional consensus to provide practical, evidence-based guidance tailored to the Asian context.\n\nMethods: A multidisciplinary task force comprising 24 voting members and 5 non-voting facilitators from across Asia was convened. Experts were divided into four 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.\n\nResults: 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.\n\nConclusions: This ANMA/APAGE consensus provides a practical, algorithm-based framework to improve management of chronic constipation across diverse Asian healthcare settings.", "abstract_shown": true, "affiliations": [ "Division of Gastroenterology, Department of Medicine, King Chulalongkorn Memorial Hospital, Thai Red Cross Society Bangkok Thailand", "Center of Excellence in Neurogastroenterology and Motility, Faculty of Medicine, Chulalongkorn University Bangkok Thailand", "Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore Singapore", "Division of Gastroenterology and Hepatology, Department of Medicine, National University Hospital Singapore", "Division of Gastroenterology, Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia Jakarta Indonesia", "Department of Gastroenterology and Hepatology, International University of Health and Welfare and Atami Hospital Shizuoka Japan", "Division of Gastroenterology and Hepatology, Department of Internal Medicine, Tokai University School of Medicine, Isehara Kanagawa Japan", "School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu Malaysia", "Department of Gastroenterology, Juntendo University Faculty of Medicine Tokyo Japan", "Department of Physiology, Faculty of Medicine, Chulalongkorn University Bangkok Thailand", "Division of Gastroenterology, Union Hospital of Tongji Medical College, Huazhong University of Science and Technology Wuhan China", "Department of Gastroenterology and Hepatology, Singapore General Hospital Singapore", "Department of Medicine, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation and Tzu Chi University, Hualien Taiwan", "Endoscopy Center in Diagnosis and Treatment, Taipei Veterans General Hospital Taipei City Taiwan", "Institute of Brain Science, National Yang Ming Chiao Tung University Hsinchu Taiwan", "Department of Internal Medicine, University of Medicine and Pharmacy at Ho Chi Minh City Vietnam", "Department of Gastroenterology, Nhan Dan Gia Dinh Hospital Ho Chi Minh City Vietnam", "Department of Gastroenterology and Human Nutrition, All India Institute of Medical Sciences New Delhi India", "Department of Medicine & Therapeutics, The Chinese University of Hong Kong Hong Kong", "Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine Seoul Korea", "Department of Medicine, Faculty of Medicine, Universiti Malaya Kuala Lumpur Malaysia", "School of Biological Sciences, Nanyang Technological University Singapore", "Department of Gastroenterology, Manikganj Medical College, Manikganj Bangladesh", "Institute for Digestive Research, Digestive Disease Center, Soonchunhyang University Seoul Hospital Seoul Korea", "Institute of Gastrosciences & Liver Transplantation, Apollo Multispeciality Hospitals Kolkata India", "Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College Beijing China", "Department of Gastroenterology and Hepatology, Sun Yat-sen University, China; and Bangkok Thailand", "Gastrointestinal Motility Unit, Digestive Disease Center, Bumrungrad International Hospital Bangkok Thailand" ], "article_type": "review article", "arxiv": null, "author_total": 29, "authors": [ { "affs": [ 0, 1 ], "name": "Tanisa Patcharatrakul", "orcid": "0000-0003-1324-2394" }, { "affs": [ 2, 3 ], "name": "Kewin T. H. Siah", "orcid": "0000-0002-2795-5101" }, { "affs": [ 4 ], "name": "Ari Fahrial Syam", "orcid": "0000-0003-0041-3553" }, { "affs": [ 5 ], "name": "Atsushi Nakajima", "orcid": "0000-0002-6263-1436" }, { "affs": [ 6 ], "name": "Hidekazu Suzuki", "orcid": "0000-0002-8994-6163" }, { "affs": [ 7 ], "name": "Yeong Yeh Lee", "orcid": "0000-0002-6486-7717" }, { "affs": [ 8 ], "name": "Mariko Hojo", "orcid": "0000-0001-9671-5585" }, { "affs": [ 1, 9 ], "name": "Pakkapon Rattanachaisit", "orcid": "0000-0003-3524-1712" }, { "affs": [ 0, 1 ], "name": "Panyavee Pitisuttithum", "orcid": "0000-0002-3530-3621" }, { "affs": [ 3 ], "name": "Sabrina Quek", "orcid": "0000-0001-5377-1528" }, { "affs": [ 10 ], "name": "Tao Bai", "orcid": "0000-0001-9697-8510" }, { "affs": [ 3 ], "name": "Yi Ping Ren", "orcid": "0000-0003-1241-4537" }, { "affs": [ 8 ], "name": "Akihito Nagahara", "orcid": "0000-0001-5979-4384" }, { "affs": [ 11 ], "name": "Andrew Ming-Liang Ong", "orcid": "0000-0002-9199-2038" }, { "affs": [ 12 ], "name": "Chien-Lin Chen", "orcid": "0000-0002-9084-8210" }, { "affs": [ 13, 14 ], "name": "Ching-Liang Lu", "orcid": "0000-0001-9335-7241" }, { "affs": [ 15, 16 ], "name": "Duc Trong Quach", "orcid": "0000-0003-0141-921X" }, { "affs": [ 17 ], "name": "Govind K. Makharia", "orcid": "0000-0002-2474-2194" }, { "affs": [ 18 ], "name": "Justin C. Y. Wu", "orcid": "0000-0002-2846-9818" }, { "affs": [ 19 ], "name": "Kee Wook Jung", "orcid": "0000-0002-3771-3691" }, { "affs": [ 20 ], "name": "Kee Huat Chuah", "orcid": "0000-0001-9811-7546" }, { "affs": [ 21 ], "name": "Linda Zhong", "orcid": "0000-0002-3877-1914" }, { "affs": [ 22 ], "name": "M. Masudur Rahman", "orcid": "0000-0002-9713-2223" }, { "affs": [ 23 ], "name": "Tae Hee Lee" }, { "affs": [ 24 ], "name": "Uday C. Ghoshal", "orcid": "0000-0003-0221-8495" }, { "affs": [ 10 ], "name": "Xiaohua Hou", "orcid": "0000-0002-4777-7920" }, { "affs": [ 25 ], "name": "Xiucai Fang", "orcid": "0000-0002-5600-8779" }, { "affs": [ 26 ], "name": "Ying-Lian Xiao", "orcid": "0000-0002-4223-4943" }, { "affs": [ 0, 27 ], "name": "Sutep Gonlachanvit", "orcid": "0000-0002-8279-8778" } ], "bibtex": "https://research.draconitic.com/paper/50skg64tk0b64.bib", "cited_by": 0, "doi": "10.5056/jnm26076", "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13725373/", "id": "50skg64tk0b64", "issns": [ "2093-0879", "2093-0887" ], "landing_url": "https://doi.org/10.5056/jnm26076", "language": "en", "licence": "CC-BY-NC-4.0", "licence_label": "CC BY-NC 4.0", "licence_source": "article", "licence_url": "https://creativecommons.org/licenses/by-nc/4.0/", "metadata_licence": null, "native_subjects": [ [ "heading", "Review" ], [ "openalex", "2715|Gastrointestinal motility and disorders" ] ], "openalex": "W7204535365", "pdf_url": "https://www.jnmjournal.org/journal/download_pdf.php?doi=10.5056/jnm26076", "pmcid": "PMC13725373", "pmid": "42663077", "published": "2026-10-31", "publisher": "The Korean Society of Neurogastroenterology and Motility", "ris": "https://research.draconitic.com/paper/50skg64tk0b64.ris", "sources": [ { "first_seen": "2026-11-04T12:23:47Z", "native_id": "PMC13725373", "source": "pmc", "url": "https://doi.org/10.5056/jnm26076" } ], "subjects": [ { "field": "medicine", "origin": "openalex:2715|Gastrointestinal motility and disorders", "subfield": "general" } ], "title": "Asian Neurogastroenterology and Motility Association and Asia-Pacific Association of Gastroenterology Chronic Constipation Consensus 2026", "title_text": "Asian Neurogastroenterology and Motility Association and Asia-Pacific Association of Gastroenterology Chronic Constipation Consensus 2026", "type": "peer-reviewed", "updated_at": "2026-11-06T12:21:39Z", "url": "https://research.draconitic.com/paper/50skg64tk0b64", "venue": "Journal of Neurogastroenterology and Motility", "versions": [] }