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Constipation is a topic covered in the Washington Manual of Medical Therapeutics.

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General Principles


Constipation consists of infrequent and incomplete bowel movements, which can be 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, pelvic floor dyssynergia) are other risk factors.1

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Williams, Dominique, et al., editors. "Constipation." Washington Manual of Medical Therapeutics, 35th ed., Wolters Kluwer Health, 2016. Washington Manual, www.unboundmedicine.com/washingtonmanual/view/Washington-Manual-of-Medical-Therapeutics/602129/all/Constipation.
Constipation. In: Williams D, Ramgopal R, Gdowski M, et al, eds. Washington Manual of Medical Therapeutics. 35th ed. Wolters Kluwer Health; 2016. https://www.unboundmedicine.com/washingtonmanual/view/Washington-Manual-of-Medical-Therapeutics/602129/all/Constipation. Accessed July 16, 2019.
Constipation. (2016). In Williams, D., Ramgopal, R., Gdowski, M., Dretler, A., & Bhat, P. (Eds.), Washington Manual of Medical Therapeutics. Available from https://www.unboundmedicine.com/washingtonmanual/view/Washington-Manual-of-Medical-Therapeutics/602129/all/Constipation
Constipation [Internet]. In: Williams D, Ramgopal R, Gdowski M, Dretler A, Bhat P, editors. Washington Manual of Medical Therapeutics. Wolters Kluwer Health; 2016. [cited 2019 July 16]. Available from: https://www.unboundmedicine.com/washingtonmanual/view/Washington-Manual-of-Medical-Therapeutics/602129/all/Constipation.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Constipation ID - 602129 ED - Williams,Dominique, ED - Ramgopal,Rajeev, ED - Gdowski,Mark, ED - Dretler,Alexandra, ED - Bhat,Pavat, BT - Washington Manual of Medical Therapeutics UR - https://www.unboundmedicine.com/washingtonmanual/view/Washington-Manual-of-Medical-Therapeutics/602129/all/Constipation PB - Wolters Kluwer Health ET - 35 DB - Washington Manual DP - Unbound Medicine ER -