Causes of Acute and Chronic Constipation
Last reviewed: 23.04.2024
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Acute stool delay suggests a physical cause; chronic stool retention can be somatic and functional.
When atony, the large intestine does not respond to the usual stimulation with food and physical activity, which contribute to defecation, or these stimuli are not enough. The patient has an infrequent stool, but does not feel the need for defecation. Atony usually develops with a decrease in the sensitivity of the rectum to caloric masses with the usual disregard of the urge to defecate or prolonged use of laxatives or enemas. This is usually characteristic of the elderly due to the age-related decline of the reflexes characteristic of the colon, the low dietary fiber content of the diet, the lack of physical activity and the use of constipation medications.
[Sharp stool retention
- Acute intestinal obstruction
- Vomiting, hernia, adhesions, coprostasis
-
Dynamic intestinal obstruction
- Medicines
- Peritonitis, craniocerebral or spinal trauma, bed rest
- Anticholinergic (antipsychotics, antiparkinsonic, spasmolytic), cations (iron, Ca, barium, bismuth), opioids, general anesthesia
Chronic chair delay
- Tumor of the large intestine
- Metabolic disorders
- CNS disorders
- Peripheral Nervous System Disorders
- Systemic disorders
- Functional violations
- Diabetes mellitus, hypothyroidism, hypercalcemia, uremia, porphyria
- Parkinson's disease, multiple sclerosis, stroke, spinal cord lesions
- Hirschsprung's disease (agangliosis), neurofibromatosis, autonomic nervous system damage
- Systemic sclerosis, amyloidosis, dermatomyositis, muscular dystrophy
- Atony of the large intestine, irritable bowel syndrome
The stigma ("stool", fecal stones), which can develop with the delay of the stool, is especially characteristic of the elderly. With age, the rectal cavity increases, and the motor activity of the colon decreases, especially with prolonged bed rest or a decrease in physical activity. This is also observed after oral administration of barium or with irrigoscopy. The patient has pain in the rectum and tenesmus, and he makes repeated but useless attempts to defecate. The patient may experience spasmodic pains, dense masses may surround watery mucus or liquid feces resembling diarrhea (paradoxical diarrhea). Examination of the rectum reveals a stony hardness of feces, but more often a paste-like feces.