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Symptoms and Signs – Differential Diagnosis of Constipation
Diet: low fibre, inadequate fluid intake
Drugs: opiates, anticholinergics (tricyclics, phenothiazines), iron
Immobility
Old age
Surgical/gastrointestinal:
Anorectal disease (fissure, stricture, rectal prolapse)
Intestinal obstruction (strictures, e.g. IBD, cancers, diverticulosis, pelvic mass,
e.g. fibroids)
Irritable bowel syndrome
Post-operative
Endocrine: hypothyroidism, hypercalcaemia, hypokalaemia, porphyria, lead
poisoning
Neurological/neuromuscular: autonomic neuropathy, spinal/pelvic nerve injury,
scleroderma, Hirschsprung's disease, Chagas' disease
Diet: low fibre, inadequate fluid intake
Drugs: opiates, anticholinergics (tricyclics, phenothiazines), iron
Immobility
Old age
Surgical/gastrointestinal:
Anorectal disease (fissure, stricture, rectal prolapse)
Intestinal obstruction (strictures, e.g. IBD, cancers, diverticulosis, pelvic mass,
e.g. fibroids)
Irritable bowel syndrome
Post-operative
Endocrine: hypothyroidism, hypercalcaemia, hypokalaemia, porphyria, lead
poisoning
Neurological/neuromuscular: autonomic neuropathy, spinal/pelvic nerve injury,
scleroderma, Hirschsprung's disease, Chagas' disease
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