From "relieving Constipation" To "regulating Gut Flora": IVD Is Reshaping The Treatment of Chronic Constipation.

From "relieving constipation" to "regulating gut flora": IVD is reshaping the treatment of chronic constipation.

For a long time, constipation has been considered a symptom rather than an independent disease. However, with the advancement of medical research, chronic constipation has been clearly defined as an independent disease requiring systematic diagnosis and classification. According to the "Chinese Expert Consensus on Examination and Assessment of Chronic Constipation (2024 Edition)," constipation can be divided into three main types: slow transit constipation, outlet obstruction constipation, and mixed constipation. Outlet obstruction constipation is the most common, while slow transit constipation is closely related to decreased colonic motility.

The diagnosis of chronic constipation must systematically rule out organic diseases and drug-related factors that may cause constipation. This includes a detailed medical history, understanding the presence of systemic diseases such as hypothyroidism, diabetes, and neurological disorders, as well as intestinal lesions such as colorectal tumors, inflammatory bowel disease, and intestinal obstruction. It requires complexity and rigor.

This necessitates in vitro diagnostic (IVD) testing.

What can IVD do?

In the routine diagnosis of constipation, multiple IVD tests provide fundamental support.

For example, a complete blood count (CBC) can reveal conditions such as anemia. In cases of iron-deficiency anemia caused by long-term chronic constipation, hemoglobin and other indicators will decrease. Biochemical tests, including liver and kidney function tests, electrolyte tests, and thyroid function tests, are crucial for ruling out constipation caused by systemic diseases such as hypothyroidism, diabetes, and hypokalemia. Stool routine tests and occult blood tests can identify the presence of red blood cells, white blood cells, and parasites in the stool. A positive occult blood test suggests possible gastrointestinal bleeding, requiring further investigation of intestinal diseases.

These traditional IVD (in vitro diagnostic) technologies are mature and have irreplaceable fundamental value in the diagnosis and treatment of constipation. They provide objective laboratory evidence for ruling out organic diseases and assessing overall health, making them an indispensable part of the constipation diagnostic process.

With the advancement of microbiome research, gut microbiota testing has become the most innovative application of IVD in the diagnosis and treatment of constipation. Gut microbiota testing is mainly accomplished through stool sample analysis, and the main techniques include metagenomic sequencing, 16S rRNA gene sequencing, culture methods, PCR technology, and metabolite detection.

For patients with constipation, gut microbiota testing can assess the balance of the gut microbiota, detect the types and quantities of beneficial and harmful bacteria, evaluate small intestinal bacterial overgrowth (SIBO), and detect microbial metabolites such as short-chain fatty acids, indirectly reflecting the functional status of the microbiota and assessing intestinal barrier function and anti-inflammatory capacity.

Besides microbiota testing, it also plays a role in assessing constipation function. For example, the colonic transit test observes the distribution and excretion of markers in the colon to indicate whether colonic transit function is abnormal. Other methods include anorectal manometry, etc.

What impact does IVD have on treatment?

Traditional constipation treatment often uses a "one-size-fits-all" approach to laxatives, lacking specificity and consistency. Clearly, in today's precision medicine era, if the application of IVD testing is strengthened and awareness of testing is enhanced, then constipation treatment will shift towards precision, individualization, and systematic health management. For example, based on gut microbiota testing results, doctors can develop personalized probiotic and prebiotic supplementation plans for patients to specifically regulate gut microbiota balance. Based on colonic transit function assessment results, it can be determined whether a patient is suitable for prokinetic drug therapy. Based on anorectal function testing results, targeted biofeedback therapy plans can be developed.

To improve comprehensive management, IVD testing is not only used for initial diagnosis but also for dynamic monitoring and efficacy evaluation during treatment. This means that gut microbiota and colonic transit function indicators are checked during routine monitoring and regular checkups, providing doctors with objective assessments of treatment effectiveness and timely adjustments to the treatment plan.

This creates dynamic management based on IVD testing, shifting the focus of chronic constipation treatment from short-term bowel regularity to long-term gut function recovery and gut microbiota balance maintenance, thus improving treatment adherence.

From 9th to 12th April, 2026, the 93rd China International Medical Equipment Fair (CMEF), was held at the National Exhibition and Convention Center (Shanghai). 

It’s with the theme of "Innovation Fusion, Infinite Transformation", took place on a grand stage covering over 320,000 square meters. It brought together nearly 5,000 brand enterprises  from more than 30 countries and regions around the world. 

The four-day exhibition attracted more than 300,000 professional visitors and over 100,000 national buyers from 150 countries and regions, and global industry professionals jointlywitnessed this annual grand event that led the development trends and innovation directions of the global medical and health industry. 

Thanks for your coming!