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Constipation and its causes

Constipation is defined as infrequent passage of hard stools less than 3 bowel movement per week. It may be a manifestation of many  gastrointestinal and medical disorders.
Features to be noted  in constipation
1,Onset 
Onset in neonatal  period- Hirschsprung's disease
2.Presence of other lower Gl symptoms such as bleeding
3.Excessive straining -is seen in Motility disorder
4.Symptoms of other system involvement to rule out
  • Hypothyroidism
  • Spinal cord disease
  • Causes of constipation 
  • Gastrointestinal and
  • Non-gastrointestinal
  • Gastrointestinal
5.Dietary habits - Lack of fibre diet and fluid intake
Colonic causes  of constipation- Motility disorder, tumor, stricture megacolon,intestinal obstruction /pseudoobstruction
Anorectal disorder -Hemorrhoids, fissure in ano, rectocoele, Megarectum
Non-gaslrointestinal causes of constipation
  • Drugs
  • Aluminium containing antacids
  • Opiates
  • Anti-cholinergic
  • Fe supplements
  • Metabolic/endocrine
  • Hypothyroidism
  • Diabetes mellitus
  • Hypercalcemia, hypokalemia
  • Porphyria
  • Pregnancy
Neuromuscular causes for constipation

Peripheral
  • Hirschsprung's disease
  • Intestinal pseudo-obstruction
Central causes of constipation
  • Parkinsonism
  • Spinal cord disease
  • CVA
  • Cauda equina lesion
  • Immobilization
  • Elderly people
  • Drugs
  • Neurological disorder
  • Psychogenic - Depressive illness.


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