Constipation Differential Diagnosis

The differential diagnosis for constipation can be organized into the following categories:

• Single Most Likely Diagnosis
  • Chronic idiopathic constipation: This is the most common cause of constipation, often related to diet, lifestyle, and bowel habits. It is characterized by infrequent bowel movements, hard stools, and difficulty passing stools.
• Other Likely Diagnoses
  • Hypothyroidism: A condition where the thyroid gland does not produce enough thyroid hormones, leading to slowed bowel movements and constipation.
  • Medication-induced constipation: Certain medications, such as opioids, antihistamines, and antacids, can cause constipation as a side effect.
  • Irritable bowel syndrome (IBS): A functional gastrointestinal disorder characterized by abdominal pain, bloating, and changes in bowel habits, including constipation.
  • Dietary factors: A low-fiber diet, inadequate fluid intake, and excessive consumption of dairy products or processed foods can contribute to constipation.
• Do Not Miss Diagnoses
  • Colorectal cancer: Although less common, colorectal cancer can cause constipation, especially if the tumor is obstructing the bowel.
  • Bowel obstruction: A blockage in the intestine can cause severe constipation, abdominal pain, and vomiting.
  • Neurological disorders: Conditions such as Parkinson's disease, multiple sclerosis, and spinal cord injuries can affect bowel function and lead to constipation.
  • Endocrine disorders: Conditions like hyperparathyroidism and diabetes can cause constipation due to altered hormone levels and nerve damage.
• Rare Diagnoses
  • Hirschsprung's disease: A congenital condition characterized by the absence of nerve cells in the colon, leading to severe constipation and intestinal obstruction.
  • Chagas disease: A parasitic infection that can cause constipation and megacolon (enlargement of the colon).
  • Amyloidosis: A condition characterized by the deposition of abnormal proteins in the body, which can affect the gastrointestinal system and cause constipation.
  • Lead poisoning: Exposure to lead can cause constipation, abdominal pain, and other gastrointestinal symptoms.