The Washington Manual of Medical Therapeutics helps you diagnose and treat hundreds of medical conditions. Consult clinical recommendations from a resource that has been trusted on the wards for 50+ years. Explore these free sample topics:
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Constipation consists of infrequent (and frequently incomplete) bowel movements, sometimes associated with straining and passage of pellet-like stools.
- Recent changes in bowel habits may suggest an organic cause, whereas long-standing constipation is more likely to be functional.
- Medications (e.g., calcium channel blockers, opiates, anticholinergics, iron supplements, barium sulfate) and systemic diseases (e.g., diabetes mellitus, hypothyroidism, systemic sclerosis, myotonic dystrophy) may contribute.
- Female gender, older age, lack of exercise, low caloric intake, low-fiber diet, and disorders that cause pain on defecation (e.g., anal fissures, thrombosed external hemorrhoids) are other risk factors (Am Fam Physician 2011;84:299 [PMID:21842777]).