© Springer International Publishing Switzerland 2017
Bobby Desai and Alpa Desai (eds.)Primary Care for Emergency Physicians10.1007/978-3-319-44360-7_1717. Constipation
(1)
Community Health and Family Medicine, University of Florida, Newberry, FL, USA
(2)
Emergency Medicine, University of Florida, Gainesville, FL, USA
Keywords
Infrequent defectionPrimary constipationSecondary constipation17.1 Introduction
Constipation is a problem affecting between 12 and 19 % of people within the United States [1] and is described as infrequent defecation and/or difficulty passing stool [2]. This condition is more common in certain groups including women, children, and the elderly [3]. The Rome criteria define functional constipation as including two or more of the following: At least 25 % of defecation involves straining, lumpy or hard stool, sensation of incomplete evacuation, sensation of anorectal obstruction/blockage, or manual maneuvers to facilitate defecation, and there are fewer than three defecations per week [4]. Additionally, loose stool are rarely present without use of laxatives, and there are insufficient criteria for irritable bowel syndrome.
17.2 Primary Constipation
Normal transit constipation – functional constipation – most common.
Stool passes through the colon at a normal rate.
Slow transit constipation – prolonged delay of passage of stool through the colon [5].
Anorectal dysfunction – inefficient coordination of the pelvic musculature in the evacuation mechanism [7].
Patients complain of feeling of incomplete emptying, sensing obstruction, or a need for digital manipulation.
Usually is an acquired behavioral disorder.
17.3 Secondary Constipation: Wide Array of Sources [8–10]
Endocrine/metabolic disorders:
Hyperparathyroidism
Diabetes mellitus
Uremia
Hypercalcemia
Hypothyroidism
Myopathic conditions:
Amyloidosis
Myotonic dystrophy
Scleroderma
Neurologic diseases:
Autonomic neuropathy
Cerebrovascular disease
Hirschsprung’s disease
Multiple sclerosis
Parkinson’s disease
Spinal cord injury/tumorFull access? Get Clinical Tree