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 #Constipation #Causes #Differential #Diagnosis
