Differential Diagnosis
- Single most likely diagnosis
- Constipation due to medication side effects (e.g., cyclobenzaprine) and dehydration: The patient's recent use of cyclobenzaprine, a muscle relaxer known to cause constipation, combined with inadequate hydration and a disrupted routine, makes this a likely cause of their constipation.
- Other Likely diagnoses
- Constipation due to decreased physical activity and travel: The patient's travel schedule and potential decrease in physical activity may have contributed to their constipation.
- Functional constipation: The patient's symptoms, including infrequent bowel movements and difficulty passing stools, are consistent with functional constipation.
- Back pain-related constipation: The patient's severe back pain may be causing them to avoid physical activity, leading to constipation.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Cauda equina syndrome: Although the patient denies new onset loss of bowel or bladder control and numbness or tingling in the perineal region, cauda equina syndrome is a medical emergency that requires prompt attention. The patient's severe back pain and constipation warrant consideration of this diagnosis.
- Spinal cord compression: Similar to cauda equina syndrome, spinal cord compression is a serious condition that can cause constipation, back pain, and neurological symptoms.
- Intestinal obstruction: Although less likely, intestinal obstruction can cause severe constipation, abdominal pain, and vomiting.
- Rare diagnoses
- Neurogenic bowel dysfunction: This condition, which can cause constipation, is often associated with neurological disorders such as multiple sclerosis or spinal cord injuries.
- Endocrine disorders (e.g., hypothyroidism): Certain endocrine disorders can cause constipation, although this is less likely given the patient's presentation.
- Colonic inertia: A rare condition characterized by a decrease in colonic motility, leading to severe constipation.