Table 1 Common causes of secondary constipationᅟ

Drugs

Anabolic steroids, analgesics, opioids (codeine), NSAIDs, anticholinergics, anticonvulsivants, antidepressants, antihistamines, antihypertensives (verapamil e clonidine), anti-Parkinsonian, diuretics, antiacids containing calcium or alluminium, cholestyramine.

Neuropathic and myopathic disorders

Amyloidosis, Chagas disease, connective tissue disorders, CNS lesions, autonomic diabetic neuropathy, Hirschprung’s disease, multiple sclerosis.

Idiopathic

Paraneoplastic syndromes, Parkinson’s disease, dementia, scleroderma, post-viral colon-paresis, intestinal pseudo-obstruction, spinal or ganglion tumor, ischemia.

Electrolytic balance alterations

Hypokalemia, hypercalcemia

Organic intestinal diseases

Obstruction/stenosis: adenoma, cancer, diverticolitis, rectocele, hernia, foreign bodies, faecal impaction, IBD and complications.

Anorectal abnormalities: anal stenosis or fissures, proctitis, rectocele, haemorrhoids.

Hypothyroidism, diabetes mellitus, pregnancy and childbirth, dehydration, low fibres intake diet, hyperglycemia

Endocrine-metabolic causes