Causes of Constipation in Adults

Most common

 - Inadequate fiber or fluid intake

 - Poor bowel habits

Systemic disease

 - Endocrine: hypothyroidism, hyperparathyroidism, diabetes mellitus

 - Metabolic: hypokalemia, hypercalcemia, uremia, porphyria

 - Neurologic: Parkinson disease, multiple sclerosis, sacral nerve damage (prior pelvic surgery, tumor), paraplegia, autonomic neuropathy

Medications

 - Opioids

 - Diuretics

 - Calcium channel blockers

 - Anticholinergics

 - Psychotropics

 - Calcium and iron supplements

 - NSAlDs

 - Clonidine

 - Cholestyramine

Structural abnormalities

 - Anorectal: rectal prolapse, rectocele, rectal intussusception, anorectal stricture, anal fissure, solitary rectal ulcer syndrome

 - Perineal descent

 - Colonic mass with obstruction: adenocarcinoma

 - Colonic stricture: radiation, ischemia, diverticulosis

 - Hirschsprung disease

 - Idiopathic megarectum

Slow colonic transit

 - Idiopathic: isolated to colon

 - Psychogenic

 - Eating disorders

 - Chronic intestinal pseudo-obstruction

Pelvic floor dyssynergia

Irritable bowel syndrome



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