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 or lumpy stools, and difficulty passing stools.
- Other Likely Diagnoses
- Hypothyroidism: An underactive thyroid gland can cause constipation due to decreased gut motility.
- Medication side effects (e.g., opioids, anticholinergics, iron supplements): Many medications can slow down bowel movements, leading to constipation.
- Dietary factors (e.g., low fiber intake, dehydration): A diet low in fiber and inadequate fluid intake can contribute to constipation.
- Irritable bowel syndrome (IBS): A functional gastrointestinal disorder characterized by abdominal pain, bloating, and changes in bowel habits, including constipation.
- Do Not Miss Diagnoses
- Colorectal cancer: Although less common, colorectal cancer can cause constipation, especially if there is a significant change in bowel habits.
- Intestinal obstruction: A blockage in the intestine can cause severe constipation, abdominal pain, and vomiting.
- Neurological disorders (e.g., Parkinson's disease, multiple sclerosis): Certain neurological conditions can affect bowel function, leading to constipation.
- Endocrine disorders (e.g., diabetes, hyperparathyroidism): Hormonal imbalances can affect gut motility and cause constipation.
- Rare Diagnoses
- Hirschsprung's disease: A congenital condition characterized by the absence of nerve cells in the colon, leading to severe constipation.
- Chagas disease: A parasitic infection that can cause constipation due to damage to the nerves in the colon.
- Amyloidosis: A condition characterized by the deposition of abnormal proteins in the body, which can affect the gut and cause constipation.
- Lead poisoning: Exposure to lead can cause constipation, as well as other neurological and gastrointestinal symptoms.