Skip to Content
Interactive Textbook on Clinical Symptom Research Logo


Home Button

Clinical Research: Constipation Sections
Author Biography
Introduction
What is constipation?
Understanding the problem
Objective Measurement
Subjective Measurement
Measuring Components
Currently Selected Section: Precipitating Factors
Therapeutic Comparisons
Research Questions
Conclusion




Chapter 3: Methods for Clinical Research in Constipation: Precipitating Factors in Constipation
          

In a population of chronically constipated patients who are otherwise healthy, the physical cause of their symptoms is some combination of intrinsic and acquired neuromuscular defects in the gut.

Conversely, in patients who experience constipation in the context of other disease, its origins are often multifactorial. The potential influence of these factors has been inferred from clinical or physiological observations, or from the pharmacological properties of drugs; however, it is much harder to tease out their relative contributions in an ill population.

Table 7.1 CAUSES OF CONSTIPATION IN MEDICAL PATIENTS [adapted from Sykes, Oxford Textbook of Palliative Medicine (2nd edition)1998]

Secondary Effects of Disease

Drugs

Malignancy

Concurrent Disease

Inadequate food intake

Low fiber diet

Dehydration

Weakness

Inactivity

Confusion

Depression

Unfamiliar toilet arrangements

Opioids

Drugs w/ anticholinergic effects (hyoscine, phenothiazines, tricyclic antidepressants, antiparkinsonian agents)

Antacids (calcium and aluminium compounds)

Diuretics

Anticonvulsants

Iron

Antihypertensive agents

Vinca alkaloids

Intestinal obstruction due to: tumour in the bowel wall, or external compression by abdominal or pelvic tumour

Damage to lumbosacral spinal cord, cauda equina or pelvic plexus

Hypercalcemia

Diabetes

Hypothyroidism

Hypokalemia

Hernia

Diverticular disease

Rectocele

Anal fissure or stenosis

Anterior mucosal prolapse

Hemorrhoids

Colitis


Page 17 of 36
      Previous Section