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