Definition

Constipation consists of infrequent and incomplete bowel movements, which can be associated with straining and passage of pellet-like stools.

Etiology

• 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