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Related to constipation

Medications Induced constipation

OTC medications causing constipation

  • Analgesics (NSAIDs, Opioids)
  • Antacids (eg Calcium and Aluminium containing, bismuth)
  • Antihistamines (eg diphenhydramine, cetirizine)
  • Calcium supplements
  • Hematinic (especially iron)
  • Sucralfate
  • Serotonin antagonist (eg ondansetron)

Prescription medications causing constipation

  • Anticholinergics (eg benztropine, glycopyrrolate)
  • Anticonvulsants (eg carbamazepine, divalporate)
  • Antidepressants (specifically amitriptyline)
  • Antihistamines (et diphenhydramine, cetrizine)
  • Polysterene sodium sulfate
  • Antimuscarinics (eg oxybutynin, tolterodine)
  • Benzodiazepines (esp alprazolam and estazolam)
  • Sedatives (eg zolpidem, BZDs, phenobarbital)
  • CCBs (eg verapamil, diltiazem)
  • Diuretics (e.g HCZ, furesomide)
  • Hematinics (e.g iron)
  • Hyperlipidimics (eg cholestyramine, pravastatin, simvastatin)
  • Hypotensives (eg ACEI, beta blockers)
  • muscle relaxants (eg. cyclobenzaprine, metaxalane)
  • Opiates (eg. odeine, morphine)
  • Parkinsonism agents (eg. bromcriptine)
  • Psychotherapeuric drugs (eg phenothiazines, butyrophenones)

Disease induced constipation

  • Disorders of the Large Intestine, Rectum, and Anus
    • Anal fissure: A small tear in the anus that causes pain, leading to withholding stool and constipation.
    • Chronic amebiasis: A long-term parasitic infection of the intestine that can inflame the gut and disrupt normal bowel function.
    • Colonic inertia: Weak colon muscles that fail to move stool effectively, resulting in slow transit and constipation.
    • Diverticulitis: Inflammation of pouches in the colon that can narrow the passage and disrupt muscle contractions.
    • Hernias: A protrusion of an organ through a muscle wall that can indirectly affect bowel function by compressing nearby structures.
    • Internal rectal prolapse: Slipping of the rectum inside itself, which can obstruct stool passage or impair evacuation.
    • Irritable bowel syndrome (IBS): A disorder with altered bowel habits, where constipation-predominant IBS involves slowed colon motility.
    • Ischemic colitis: Reduced blood flow to the colon damages tissue and impairs muscle contractions needed for stool movement.
    • Mucosal prolapse: Slipping of the rectal lining through the anus, which can obstruct stool passage.
    • Pelvic floor dysfunction and lesions: Weak or uncoordinated pelvic muscles that make it difficult to expel stool effectively.
    • Rectocele: A bulge of the rectum into the vagina that can hinder complete stool evacuation.
    • Stenotic obstruction: Narrowing of the colon that physically blocks the passage of stool.
    • Strictures: Narrowing of the colon, often from scarring, that impedes stool movement.
    • Surgical stricture (end-to-end anastomosis): Narrowing at a surgical connection in the colon that obstructs stool flow.
    • Tumors: Growths in the colon or rectum that can obstruct the bowel.
    • Ulcerative proctitis: Inflammation of the rectum that disrupts normal bowel function.
  • Metabolic Disorders
    • Amyloidosis: Abnormal protein deposits that damage nerves and muscles in the intestine, impairing motility.
    • Diabetic ketoacidosis: Severe metabolic imbalance in diabetes that can slow down gut function.
    • Diabetic neuropathy: Nerve damage from diabetes that disrupts signals to the intestinal muscles.
    • Hypercalcemia: High calcium levels in the blood that interfere with muscle and nerve function in the colon.
    • Hypokalemia: Low potassium levels in the blood that impair muscle contractions in the intestine.
    • Hypomagnesemia: Low magnesium levels in the blood that affect muscle and nerve function in the gut.
    • Porphyria: Disorders affecting heme production that can disrupt nerve function and bowel motility.
    • Uremia: Buildup of waste products in the blood due to kidney failure that slows down digestion.
  • Endocrine Disorders
    • Pseudohypoparathyroidism: Resistance to parathyroid hormone that disrupts calcium balance and affects gut motility.
    • Hyperparathyroidism: Overactive parathyroid glands that cause high calcium levels and impair bowel function.
    • Milk-alkali syndrome: High calcium intake that can disrupt bowel motility.
    • Carcinomatosis: Widespread cancer that disrupts various bodily functions, including digestion.
    • Hypothyroidism: Underactive thyroid that slows down metabolism and gut motility.
    • Panhypopituitarism: Underactive pituitary gland that leads to hormone deficiencies and can affect bowel function.
    • Pheochromocytoma: A tumor that releases excess hormones that can disrupt gut motility.
  • Neurologic Disorders
    • Aganglionosis, or Hirschsprung’s disease: Missing nerve cells in the colon that prevent normal contractions and stool passage.
    • Autonomic neuropathy: Damage to nerves controlling involuntary functions that disrupts gut motility.
    • Paraneoplastic syndrome: Immune response to cancer that can damage nerves in the gut and impair function.
    • Pseudo-obstruction: Disrupted nerve or muscle coordination in the intestine that mimics a blockage.
    • Cauda equina tumor: A tumor pressing on nerves at the spinal cord’s base, disrupting bowel control.
    • Cerebrovascular accidents (Stroke): Brain damage that interferes with signals to the bowel, affecting motility.
    • Chagas’ disease: Parasites that damage nerves in the intestine, leading to motility problems.
    • Dementia: Cognitive decline that can impair awareness of the urge to defecate and coordination of bowel movements.
    • Ganglioneuromatosis: Abnormal nerve tissue growth in the intestine that disrupts its function.
    • Multiple sclerosis: A disease that damages the central nervous system and disrupts signals to the bowel.
    • Parkinson’s disease: A neurological disorder that affects muscle control throughout the body, including the intestines.
    • Shy-Drager syndrome: A degenerative neurological disorder that impairs autonomic functions, including bowel control.
    • Systemic sclerosis: An autoimmune disease that damages smooth muscles in the digestive tract, impairing motility.
    • Tumors: Growths in the brain or spinal cord that can disrupt nerve signals to the bowel.
  • Muscular Disorders
    • Dermatomyositis: Muscle inflammation that weakens intestinal muscles, impairing their ability to move stool.
    • Myotonic dystrophy: An inherited muscle disorder that affects smooth muscle function in the intestines.
    • Segmental dilatation of the colon: A widened section of the colon that loses its ability to contract effectively.
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