Medical expert of the article
New publications
Causes of acute and chronic constipation
Last reviewed: 04.07.2025
All iLive content is medically reviewed or fact checked to ensure as much factual accuracy as possible.
We have strict sourcing guidelines and only link to reputable media sites, academic research institutions and, whenever possible, medically peer reviewed studies. Note that the numbers in parentheses ([1], [2], etc.) are clickable links to these studies.
If you feel that any of our content is inaccurate, out-of-date, or otherwise questionable, please select it and press Ctrl + Enter.
Acute constipation suggests a somatic cause; chronic constipation may be somatic or functional.
In atony, the colon does not respond to the usual stimulation of food and physical activity that promote defecation, or these stimuli are insufficient. The patient has infrequent bowel movements, but does not feel the need to defecate. Atony usually develops when the rectum becomes less sensitive to feces due to habitual neglect of the urge to defecate or long-term use of laxatives or enemas. It is usually characteristic of the elderly due to age-related decline in colonic reflexes, low dietary fiber, insufficient physical activity, and use of medications that cause constipation.
[ Acute constipation
- Acute intestinal obstruction
- Volvulus, hernia, adhesions, coprostasis
Dynamic intestinal obstruction
- Medicines
- Peritonitis, traumatic brain or spinal injury, bed rest
- Anticholinergics (neuroleptics, antiparkinsonians, antispasmodics), cations (iron, Ca, barium, bismuth), opioids, general anesthesia
Chronic constipation
- Colon tumor
- Metabolic disorders
- CNS disorders
- Peripheral nervous system disorders
- Systemic disorders
- Functional disorders
- Diabetes mellitus, hypothyroidism, hypercalcemia, uremia, porphyria
- Parkinson's disease, multiple sclerosis, stroke, spinal cord injury
- Hirschsprung's disease (aganglionosis), neurofibromatosis, autonomic nervous system disorder
- Systemic sclerosis, amyloidosis, dermatomyositis, muscular dystrophy
- Atony of the colon, irritable bowel syndrome
Fecal impaction (fecal impaction, fecal stones), which may develop with stool retention, is especially common in the elderly. With age, the rectal cavity increases in size and colon motility decreases, especially with prolonged bed rest or decreased physical activity. This is also observed after oral barium intake or with irrigoscopy. The patient experiences pain in the rectum and tenesmus, and makes repeated but futile attempts to defecate. The patient may experience spasmodic pain, and the dense masses may be surrounded by watery mucus or liquid feces, resembling diarrhea (paradoxical diarrhea). Rectal examination reveals stony hardness of feces, but more often putty-like feces.