ETIOLOGIES OF CHRONIC CONSTIPATION

Systemic Causes

     Diet

          Low fiber intake

          Low fluid intake

     Medications

          Antidepressants

          Anticholinergics

          Antihypertensives

               Calcium channel blockers

               Diuretics

               Clonidine HCl

          Narcotics

          Calcium supplements

          Iron supplements

          Antacids (aluminum and calcium based)

          Minerals/metals (arsenic, lead, iron)

          Anticonvulsants

          Cholestyramine

          NSAIDs

          Antiparkinsonians

          Antipsychotics

     Hypercalcemia

     Hypokalemia

     Hypothyroidism

     Diabetes mellitus

     Renal failure

     Hypopituitarism

     Porphyria

     Amyloidosis

     Pregnancy

     Multiple sclerosis

     Systemic sclerosis (scleroderma)

     Polymyositis

     Parkinson’s disease

     Chaga’s disease

     Cerebral vascular accident (CVA)

     von Recklinghausen’s disease

     Intracranial tumors

     Spinal cord injury

     Syphilis (tertiary)

     Depression

Mechanical

     Colorectal cancer

     Radiation induced strictures

     Ischemic colitis

     Diverticular disease

     Anal stenosis

     Rectal prolapse

     Rectocele

     Volvulus

     Hirshsprung’s disease

     Anorectal fissure

Functional

     Irritable bowel syndrome

     Pelvic floor dysfunction

          Rectocele

          Enterocele

          Cystocele

          Uterine prolapse

          Pelvic floor trauma secondary to prior vaginal child birth

          Menopause without estrogen replacement

     Slow transit constipation