Constipation causes: Difference between revisions

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Revision as of 01:55, 29 January 2015

Constipation Microchapters

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Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Constipation from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic Study of Choice

History and Symptoms

Physical Examination

Laboratory Findings

Abdominal X Ray

CT

MRI

Ultrasound

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Treatment

Medical Therapy

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Primary Prevention

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Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Constipation On the Web

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Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

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Directions to Hospitals Treating Constipation

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, acetaminophen, 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, Bicalutamide, bile acid sequestrant, bortezomib, bromocriptine, buspirone, butabarbital, Butorphanol, calcitriol, calcium carbonate, capecitabine, caspofungin acetate, carbamazepine, carbidopa, carboplatin, carfilzomib, carteolol, cerivastatin, cetuximab, chlordiazepoxide, chloropyramine, chlorpromazine, chlorpropamide, cholestyramine, cidofovir, cimetidine, cisapride, citalopram, cladribine, clobazam, clofarabine, clomipramine, clonazepam, clonidine, clorazepate, clozapine, codeine, colesevelam, colestipol, colofac, crizotinib, cyclizine, Cyclobenzaprine, 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, Efavirenz, enfuvirtide, epoetin alfa, Eribulin, esomeprazole, estazolam, estradiol, ethcathinone, ethosuximide, ethylmorphine, etodolac, etoposide, everolimus, famotidine, felbamate, felodipine, fenofibrate, fenoprofen, fentanyl, ferrous sulfate, fesoterodine, fludarabine phosphate, fluorouracil, fluoxetine, fluphenazine, flurazepam, Flurbiprofen, 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, Hydrochlorothiazide, ibandronate, imatinib, imipramine, indomethacin, insulin lispro, interferon beta-1b, ipratropium, Irinotecan hydrochloride iron supplements, isocarboxazid, isradipine, itraconazole, Ivermectin, kaolin, Ketorolac tromethamine, lacidipine, lamivudine, lamotrigine, lansoprazole, lanthanum, leflunomide, Lenalidomide, letrozole, leuprolide, levalbuterol, levetiracetam, levodopa, levomethadyl, levorphanol, linezolid, lofepramine, lomotil, Lorcaserin, loperamide, loprazolam, lorazepam, lovastatin, lovaza, loxapine, magaldrate, Mebendazole, meclizine, meclofenamate, mefenamic acid, meperidine, meropenem, mesalamine, mesoridazine, metformin, methadone, methsuximide, methyprylon, metoprolol, Mifepristone, milnacipran hydrochloride, 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, Pentamidine Isethionate, pergolide, perphenazine, pethidine, phenelzine, phentermine, phenytoin, pholcodine, pimozide, piperacillin sodium, piroxicam, posaconazole, pramipexole, prazepam, prazosin, prednisolone, pregabalin, procarbazine, prochlorperazine, procyclidine, Progesterone, 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, Tacrolimus, tamoxifen, tapentadol, tegaserod, temazepam, temozolomide, terazosin, teriparatide, thalidomide, thioridazine hydrochloride, thiothixene, tianeptine, tiludronate, tinidazole, tiotropium, tolterodine, topiramate, topotecan, tranylcypromine, Tretinoin, triazolam, triclofos, trifluoperazine, trihexyphenidyl, trimethadione, trimipramine, tropisetron, trospium, Valganciclovir hydrochloride, valproic acid, venlafaxine, verapamil, vicodin, vigabatrin, viloxazine, vinblastine, vincristine, vindesine, vinorelbine, vorinostat, zaleplon, zidovudine, zileuton, ziprasidone, zoledronic acid, zolpidem, zonisamide, zotepine, alprazolam Zoledronate

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

  1. ↑ Caldarella MP, Milano A, Laterza F; et al. (2005). "Visceral sensitivity and symptoms in patients with constipation- or diarrhea-predominant irritable bowel syndrome (IBS): effect of a low-fat intraduodenal infusion". Am. J. Gastroenterol. 100 (2): 383–9. doi:10.1111/j.1572-0241.2005.40100.x. PMID 15667496.
  2. ↑ "Nicotine withdrawal symptoms:Constipation". helpwithsmoking.com. 2005. Retrieved 2007-06-29.
  3. ↑ Peeters B, Noens I, Philips EM, Kuppens S, Benninga MA (2013). "Autism spectrum disorders in children with functional defecation disorders". J Pediatr. 163 (3): 873–8. doi:10.1016/j.jpeds.2013.02.028. PMID 23522863.
  4. ↑ Richardson PG, Barlogie B, Berenson J, Singhal S, Jagannath S, Irwin D; et al. (2003). "A phase 2 study of bortezomib in relapsed, refractory myeloma". N Engl J Med. 348 (26): 2609–17. doi:10.1056/NEJMoa030288. PMID 12826635.
  5. ↑ Bookman ID, Redston MS, Greenberg GR (2004). "Successful treatment of cap polyposis with infliximab". Gastroenterology. 126 (7): 1868–71. PMID 15188181.
  6. ↑ Figueroa JJ, Dyck PJ, Laughlin RS, Mercado JA, Massie R, Sandroni P; et al. (2012). "Autonomic dysfunction in chronic inflammatory demyelinating polyradiculoneuropathy". Neurology. 78 (10): 702–8. doi:10.1212/WNL.0b013e3182494d66. PMC 3306161. PMID 22357716.
  7. ↑ Stanghellini V, Cogliandro RF, De Giorgio R, Barbara G, Morselli-Labate AM, Cogliandro L; et al. (2005). "Natural history of chronic idiopathic intestinal pseudo-obstruction in adults: a single center study". Clin Gastroenterol Hepatol. 3 (5): 449–58. PMID 15880314.
  8. ↑ Kárpáti S (2011). "An exception within the group of autoimmune blistering diseases: dermatitis herpetiformis, the gluten-sensitive dermopathy". Dermatol Clin. 29 (3): 463–8, x. doi:10.1016/j.det.2011.03.019. PMID 21605813.
  9. ↑ Yang LP, Plosker GL (2008). "Desvenlafaxine extended release". CNS Drugs. 22 (12): 1061–9. doi:10.2165/0023210-200822120-00008. PMID 18998743.
  10. ↑ Kikuta S, Asakage T, Nakao K, Sugasawa M, Kubota A (2008). "The aggravating factors of hyperammonemia related to 5-fluorouracil infusion--a report of two cases". Auris Nasus Larynx. 35 (2): 295–9. doi:10.1016/j.anl.2007.04.012. PMID 17826933.
  11. ↑ Kühnel A, Gross U, Doss MO (2000). "Hereditary coproporphyria in Germany: clinical-biochemical studies in 53 patients". Clin Biochem. 33 (6): 465–73. PMID 11074238.
  12. ↑ Ritchie D, Piekarz RL, Blombery P, Karai LJ, Pittaluga S, Jaffe ES; et al. (2009). "Reactivation of DNA viruses in association with histone deacetylase inhibitor therapy: a case series report". Haematologica. 94 (11): 1618–22. doi:10.3324/haematol.2009.008607. PMC 2770976. PMID 19608677.
  13. ↑ Levi N, Schroeder TV (1998). "Isolated iliac artery aneurysms". Eur J Vasc Endovasc Surg. 16 (4): 342–4. PMID 9818012.
  14. ↑ Favier R, Jondeau K, Boutard P, Grossfeld P, Reinert P, Jones C; et al. (2003). "Paris-Trousseau syndrome : clinical, hematological, molecular data of ten new cases". Thromb Haemost. 90 (5): 893–7. doi:10.1267/THRO03050893. PMID 14597985.
  15. ↑ Roma E, Adamidis D, Nikolara R, Constantopoulos A, Messaritakis J (1999). "Diet and chronic constipation in children: the role of fiber". J Pediatr Gastroenterol Nutr. 28 (2): 169–74. PMID 9932850.
  16. ↑ O'Suilleabhain P, Low PA, Lennon VA (1998). "Autonomic dysfunction in the Lambert-Eaton myasthenic syndrome: serologic and clinical correlates". Neurology. 50 (1): 88–93. PMID 9443463.
  17. ↑ Lopez-Ibor J, Guelfi JD, Pletan Y, Tournoux A, Prost JF (1996). "Milnacipran and selective serotonin reuptake inhibitors in major depression". Int Clin Psychopharmacol. 11 Suppl 4: 41–6. PMID 8923126.
  18. ↑ Hennessey A, Robertson NP, Swingler R, Compston DA (1999). "Urinary, faecal and sexual dysfunction in patients with multiple sclerosis". J Neurol. 246 (11): 1027–32. PMID 10631634.
  19. ↑ Jetmore AB, Timmcke AE, Gathright JB, Hicks TC, Ray JE, Baker JW (1992). "Ogilvie's syndrome: colonoscopic decompression and analysis of predisposing factors". Dis Colon Rectum. 35 (12): 1135–42. PMID 1473414.
  20. ↑ Partin JC, Hamill SK, Fischel JE, Partin JS (1992). "Painful defecation and fecal soiling in children". Pediatrics. 89 (6 Pt 1): 1007–9. PMID 1594338.
  21. ↑ Langston JW (2006). "The Parkinson's complex: parkinsonism is just the tip of the iceberg". Ann Neurol. 59 (4): 591–6. doi:10.1002/ana.20834. PMID 16566021.
  22. ↑ Margulies A, Metman EH, Girard JJ, Dorval ED, Bertrand J (1986). "[Severe constipation indicative of pseudohypoparathyroidism and resolved after normalization of the blood calcium]". Ann Gastroenterol Hepatol (Paris). 22 (5): 271–2. PMID 3777869.
  23. ↑ Euvrard S, Morelon E, Rostaing L, Goffin E, Brocard A, Tromme I; et al. (2012). "Sirolimus and secondary skin-cancer prevention in kidney transplantation". N Engl J Med. 367 (4): 329–39. doi:10.1056/NEJMoa1204166. PMID 22830463.
  24. ↑ Waage A, Gimsing P, Fayers P, Abildgaard N, Ahlberg L, Björkstrand B; et al. (2010). "Melphalan and prednisone plus thalidomide or placebo in elderly patients with multiple myeloma". Blood. 116 (9): 1405–12. doi:10.1182/blood-2009-08-237974. PMID 20448107.
  25. ↑ Stadtler AC, Gorski PA, Brazelton TB (1999). "Toilet training methods, clinical interventions, and recommendations. American Academy of Pediatrics". Pediatrics. 103 (6 Pt 2): 1359–68. PMID 10353954.
  26. ↑ Legha SS (1986). "Vincristine neurotoxicity. Pathophysiology and management". Med Toxicol. 1 (6): 421–7. PMID 3540519.
  27. ↑ Sforzini C, Milani D, Fossali E, Barbato A, Grumieri G, Bianchetti MG; et al. (2002). "Renal tract ultrasonography and calcium homeostasis in Williams-Beuren syndrome". Pediatr Nephrol. 17 (11): 899–902. doi:10.1007/s00467-002-0889-z. PMID 12432430.


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