Constipation
From Ganfyd
| Neither frequency nor quantity defines constipation and in the absence of disturbance to the patient these should be carefully left alone. |
A particular subclass are young women with a sluggish bowel.
Contents |
Aetiology
Congenital
Hirschsprung's disease. A short aganglionic segment in the bowel may not be obvious at first, and thus present later with severe constipation and dilation of the colon.
Psychological
Iatrogenic
A large number of drugs can cause constipation, sometimes severe
Clinical
Complications and Sequelae
- Diverticulosis is assumed to result from chronic constipation.
- Soiling in connection with stool withholding results from constipation in children
- Anal fissure
Investigations
Blood tests
- Thyroid function tests to exclude hypothyroidism.
Radiology
- Large bowel transit studies.
Treatment
Medical
- Poor evidence base for functional childhood constipation in terms of one agent better than others
- Increasing water intake alone is unlikely to be benefical[1] as it neither shortens colon transit time or determines stool bulk.
Surgical
- Anterograde continence enema
- Sigmoid colectomy (if severe megacolon)
- Colostomy

