(GP)

Overview

• Infrequent passage of stool, generally defined as ≤3 bowel movements per week
  • Absoulute Constipation ⇒ no faeces or flatus
• F>M
• Primary Constipation → most commonly due to poor diet (lack of fibre) or dehydration and insufficient exercise
• Secondary Constipation → colorectal cancer, diverticulosis, haemorrhoids, bowel obstruction, diverticulitis, IBS, hypothyroidism, drug induced (opiods) etc.
• Risk Factors → female, age >65, low fibre intake, sedentary lifestyle, medicines that induce constipation (opiates, CCBs, antipsychotics)

Making Diagnosis

Clinical Features:

• Infrequent Stools → <3 defecations/wk
• Difficult Defecation
• Excessive Straining
• Sensation of Incomplete Evacuation (Tenesmus)
• Hard Stools
• May cause confusion if impactation.
• Can cause outflow obstruction and trigger episodes of urinary retention in patients with enlarged prostates