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Disease-Induced Constipation

Metabolic • Diabetes
• Hypokalemia, hypomagnesemia

Endocrine • Hypothyroidism

Neurologic & • Parkinson’s disease
muscular • depression
Disorders in
• Tumors
large intestin,
rectum & • Colonic inertia (Prolonged colon
anus transit time )

• IBS
• Anal fissures, Anal fistula, ulcers,

hemorrhoidal veins (avoid pain)
• Tumors

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Drug- induced constipation

• Narcotic pain medications such as codeine , oxycodone
and hydromorphone

• Antidepressants such as amitriptyline and imipramine
• Anticonvulsants such as phenytoin and carbamazepine

(Tegretol®)
• Iron supplements???Assignment? All products?
• (Calcium channel blocking drugs such as diltiazem and

nifedipine
• Aluminum-containing antacids(Aluminum hydroxide and

Calcium Carbonate )
• Drugs with anticholinergic activity
• Some NSAID, antihistamines,

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