Constipation causes: Difference between revisions

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Revision as of 22:26, 23 October 2014

Constipation Microchapters

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Causes

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Epidemiology and Demographics

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Risk calculators and risk factors for Constipation

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Mugilan Poongkunran M.B.B.S [2]

Overview

Constipation in adults may be due to side effects of medications such as antispasmodics, anticholinergics, analgesics or may be associated with systemic disorders like diabetes mellitus and hypothyroidism. Idiopathic constipation should be considered once the secondary causes are ruled out and it may be associated with normal or slow colonic transit, dysfunction in defecation, or both. Constipation in childhood often resolves with age after proper guidance regarding diet, toilet training, and toileting behaviors.

Causes

Life Threatening Causes

Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated.

Common Causes

Causes by Organ System

Cardiovascular Iliac artery aneurysm, superior mesenteric artery occlusion
Chemical / poisoning Atropine poisoning, lead poisoning, opium poisoning
Dermatologic Dermatitis herpetiformis
Drug Side Effect

5-HT3 antagonist, 5-hydroxytryptophan, acamprosate, acebutolol, aldesleukin, alendronate, alfentanil, alfuzosin, alosetron, aluminium hydroxide, amiodarone, amitriptyline, amlodipine, amobarbital, anagrelide, anastrozole, aprepitant, aripiprazole, atorvastatin, atovaquone, atropine, auranofin, barium sulfate, benzatropine, benzonatate, bepridil, beta blockers, bezafibrate, bile acid sequestrant, bortezomib, buspirone, butabarbital, calcitriol, calcium carbonate, capecitabine, carbamazepine, carbidopa, carboplatin, carfilzomib, carteolol, cerivastatin, cetuximab, chlordiazepoxide, chloropyramine, chlorpromazine, chlorpropamide, cholestyramine, cidofovir, cimetidine, cisapride, citalopram, cladribine, clofarabine, clomipramine, clonazepam, clonidine, clorazepate, clozapine, codeine, colesevelam, colestipol, colofac, cyclizine, daptomycin, darbepoetin alfa, darifenacin, darunavir, desipramine, desvenlafaxine, dextroamphetamine, dextropropoxyphene, diacetyldihydromorphine, diazepam, dicyclomine, diethylcathinone, diflunisal, dihydroetorphine, diltiazem, dimenhydrinate, diphenhydramine, disopyramide, diuretic, dolasetron, dolasetron, doripenem, dosulepin hydrochloride, doxepin, droperidol, duloxetine, enfuvirtide, epoetin alfa, esomeprazole, estazolam, estradiol, ethcathinone, ethosuximide, ethylmorphine, etodolac, etoposide, everolimus, famotidine, felbamate, felodipine, fenofibrate, fenoprofen, fentanyl, ferrous sulfate, fludarabine phosphate, fluorouracil, fluoxetine, fluphenazine, flurazepam, fluvoxamine, fulvestrant, furosemide, gabapentin, ganciclovir, gatifloxacin, gemcitabine, gemfibrozil, Glipizide, glycopyrrolate, granisetron, guanethidine, guanfacine, H2 antagonist, haloperidol, hexamethonium, histone deacetylase inhibitors, hydralazine, hydrocodone, Hydrocodone bitartrate and Homatropine methylbromide, hydroxyurea, hydroxyzine, hyoscyamine, ibandronate, imatinib, imipramine, indomethacin, insulin lispro, interferon beta-1b, ipratropium, iron supplements, isocarboxazid, isradipine, itraconazole, kaolin, Ketorolac tromethamine, lacidipine, lamivudine, lamotrigine, lansoprazole, lanthanum, letrozole, leuprolide, levalbuterol, levetiracetam, levodopa, levomethadyl, levorphanol, linezolid, lofepramine, lomotil, loperamide, loprazolam, lorazepam, lovastatin, loxapine, magaldrate, meclizine, meclofenamate, mefenamic acid, meperidine, meropenem, mesalamine, mesoridazine, metformin, methadone, methsuximide, methyprylon, metoprolol, milnacipran, misoprostol, modafinil, morphine, motofen, nabumetone, Naproxen sodium, nateglinide, nefazodone, nicardipine, nifedipine, nilutamide, nimodipine, nisoldipine, nizatidine, nortriptyline, olanzapine, omeprazole, ondansetron, oxaliplatin, oxazepam, oxcarbazepine, oxybutynin, oxycodone, palonosetron, pamidronate, pancrelipase, paroxetine, peginterferon alfa-2b, pemetrexed, pergolide, perphenazine, pethidine, phenelzine, phentermine, phenytoin, pholcodine, pimozide, piperacillin sodium, piroxicam, posaconazole, pramipexole, prazepam, prazosin, prednisolone, pregabalin, procarbazine, prochlorperazine, procyclidine, promethazine, propafenone, propantheline, propoxyphene, propranolol, protriptyline, quetiapine, rabeprazole, ranitidine, ranolazine, rasagiline, reboxetine, repaglinide, ribavirin, rilmenidine, risperidone, rivastigmine, ropinirole, rosuvastatin, saquinavir, scopolamine, scopolamine, secobarbital, selegiline, sertraline, sevelamer, sibutramine, simethicone, simvastatin, sirolimus, sitaxsentan, sorafenib, sotalol, sucralfate, sufentanil, sulindac, sunitinib, suxamethonium chloride, tamoxifen, tapentadol, tegaserod, temazepam, temozolomide, terazosin, teriparatide, thalidomide, thioridazine, thiothixene, tianeptine, tiludronate, tinidazole, tiotropium, tolterodine, topiramate, topotecan, tranylcypromine, triazolam, triclofos, trifluoperazine, trihexyphenidyl, trimethadione, trimipramine, tropisetron, trospium, valproic acid, venlafaxine, verapamil, vicodin, vigabatrin, viloxazine, vinblastine, vincristine, vindesine, vinorelbine, vorinostat, zaleplon, zidovudine, zileuton, ziprasidone, zoledronic acid, zolpidem, zonisamide, zotepine, alprazolam

Ear Nose Throat No underlying causes
Endocrine

Conn's syndrome, diabetes mellitus, glucagonoma, Hashimoto's thyroiditis, hyperparathyroidism, hypothyroidism, multiple endocrine neoplasia, myxedema, panhypopituitarism, parathyroid adenoma, pheochromocytoma, primary parathyroid hyperplasia, pseudohypoparathyroidism

Environmental Cow’s milk intolerance
Gastroenterologic

Anal atresia, anal carcinoma, ascites, bowel adhesion, bowel obstruction, cap polyposis, celiac disease, chronic amebiasis, colectomy, colonic stricture, colorectal cancer, congenital malformation, corrosive enemas, Crohn's disease, diverticular stricture, diverticulitis, enterocele, eosinophilic colitis, extrinsic compression, gastroptosis, hernia, Hirschsprung's disease, ileus, imperforate anus, inflammatory bowel disease, intraabdominal/pelvic tumors, intussusception, irritable bowel syndrome, ischemic colitis, megacolon, megarectum, Ogilvie's syndrome, painful defecation, paralytic ileus, pelvic masses, pelvic tumors, perianal abscess, proctitis, rectal cancer, rectal prolapse, rectal ulcer, rectocele, ulcerative colitis, visceral myopathies, volvulus, wandering spleen

Genetic

Batten disease, Berdon syndrome, cerebral palsy, Cornelia de Lange syndrome, cystic fibrosis, Down syndrome, gastroschisis, hereditary coproporphyria, hereditary internal anal sphincter myopathy, megacolon, megarectum, prune belly syndrome

Hematologic

Acute intermittent porphyria, amyloidosis, hereditary coproporphyria, iron deficiency anemia

Iatrogenic

Adjustable gastric band, colectomy, painful defecation, peritoneal dialysis, postoperative complications, postoperative ileus, toilet training issues, upper gastrointestinal series

Infectious Disease

Blastocystosis, botulism, chagas disease, chronic amebiasis, hookworm, lassa fever, lymphogranuloma venereum, syphilis, tuberculosis, typhoid fever, opisthorchis infection, polio

Musculoskeletal / Ortho Ankylosing spondylitis, Guillain-Barre syndrome, Lambert-Eaton myasthenic syndrome, muscular dystrophy, osteitis fibrosa cystica, paraplegia, spinal cord injury, spinal cord tumor
Neurologic

Amyotrophic lateral sclerosis, autonomic neuropathy, cerebral palsy, chagas disease, chronic inflammatory demyelinating polyneuropathy, diabetes mellitus, Guillain-Barre syndrome, Hirschsprung's disease, intestinal neuronal dysplasia, Lambert-Eaton myasthenic syndrome, meningocele, multiple sclerosis, muscular dystrophy, neurofibromatosis, occult spinal dysraphism sequence, paraplegia, parkinson's disease, progressive supranuclear palsy, pseduoobstruction, scleroderma, spina bifida, spinal cord injury, spinal cord lesions, static encephalopathy, tabes dorsalis, tethered spinal cord syndrome

Nutritional / Metabolic

Cow’s milk intolerance, food intolerance, hypercalcemia, hypervitaminosis D, hypokalemia, iron deficiency anemia, ketogenic diet, lack of fiber, low residue diet, milk-alkali syndrome, severe dehydration, starvation

Obstetric/Gynecologic Childbirth, complication of pregnancy, extremely low birth weight, ovarian cancer, rectovaginal or bowel endometriosis, uterine fibroid
Oncologic Colorectal cancer, intraabdominal/pelvic tumors, multiple endocrine neoplasia (MEN 2b), neuroblastoma, ovarian cancer, parathyroid adenoma, rectal carcinoma, renal cell carcinoma, sacrococcygeal teratoma, spinal cord tumor, stomach cancer, uterine fibroid
Opthalmologic No underlying causes
Overdose / Toxicity Acamprosate, amiodarone, atropine, carboplatin, fentanyl, phenytoin, hypervitaminosis D, haloperidol
Psychiatric

Anorexia nervosa, autism, bipolar disorder, eating disorder, emotional stress, major depression, obsessive compulsive disorder, pseudocyesis, psychosis

Pulmonary Cystic fibrosis
Renal / Electrolyte Hypercalcemia, hypokalemia, renal cell carcinoma, severe dehydration, uremia
Rheum / Immune / Allergy

Amyotrophic lateral sclerosis, ankylosing spondylitis, chronic inflammatory demyelinating polyneuropathy, cow’s milk intolerance, food intolerance, Guillain-Barre syndrome, Lambert-Eaton myasthenic syndrome, Rett syndrome, scleroderma

Sexual Tabes dorsalis
Trauma Spinal cord injury
Urologic Urogenital neoplasm
Miscellaneous

Dietary pattern change, dieting, extended bed rest, functional constipation, idiopathic, normal aging, smoking cessation, SSRI discontinuation syndrome, travel constipation

Causes in Alphabetical Order


References

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