Constipation is a commonly occurring symptom. When left untreated or undertreated, it may be associated with significant morbidity and mortality. A thorough review of the medical literature has revealed several case reports, including catastrophic and/or fatal complications related to unaddressed/not previously diagnosed constipation. A retrospective study was conducted at a community hospital on 100 consecutive patients who had presented with Gastrointestinal (G.I.) symptoms, and all of whom had colonic fecal stool scores of > 7/12 on plain Abdominal X rays (AXR). The study revealed that the p-value was < 0.001 for comparing the plain AXR positivity for Excessive Colonic Fecal Retention (ECFR) ) by the author (100%) versus the radiologist’s report (56%). While only 46% of patients had complained of constipation, only 24% were probably adequately treated with laxatives and/or stool softeners for ECFR. As per the study data, imagine the unknown prevalence of silent constipation in the pediatric and/or cognitively impaired adult population. If left untreated/undertreated, Silent Constipation may potentially give rise to Excessive Colonic Feces Maintained Mega Gut (ECFMG) syndrome. The author concurs 1. Radiologists and clinicians, irrespective of the specialty or subspecialty, other healthcare providers, ought to be proactive in reporting/diagnosing/addressing and appropriately managing Constipation/Silent Constipation to prevent ECFMG Syndrome; 2. Clinicians across all specialties, including nursing staff and auxiliary healthcare providers, should be educated on approaching, facilitating, and/or adequately addressing constipation/silent constipation; 3. An interdisciplinary approach may be needed, tailored to every patient’s needs, which can be variable, for each patient over different periods of health care.

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Esphani, N. (2019). Constipation/silent constipation/ECFMG syndrome: Under/never instructed, although a potentially lethal. International Journal of Health and Medical Sciences, 5(1), 17-28. doi: https://dx.doi.org/10.20469/ijhms.5.30003-1