William C. Shiel Jr., MD, FACP, FACR
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
In this Article
- Constipation facts
- What is constipation?
- What causes constipation?
- Medications that cause constipation
- Other causes of constipation
- What are constipation symptoms?
- How is constipation diagnosed (evaluated)?
- Exams and tests
- Imaging studies and other tests
- What treatments are available for constipation?
- Dietary fiber and bulk-forming laxatives to treat constipation
- Other laxatives to treat constipation
- Other laxatives and OTC products to treat constipation
- Prescription drugs to treat constipation
- Other treatments for constipation
- What is the approach to the evaluation and treatment of constipation?
- When should I seek medical care for chronic constipation?
- What is new in the treatment of constipation?
- Pictures of Constipation Myths and Facts - Slideshow
- Pictures of Irritable Bowel Syndrome (IBS) - Slideshow
- Pictures of What's Causing Your Pelvic Pain - Slideshow
What causes constipation?
Theoretically, constipation can be caused by the slow passage of digesting food through any part of the intestine. Most of the time, however, the slowing occurs in the colon.
Medications that cause constipation
A frequently over-looked cause of constipation is medications. The most common offending medications include:
- Narcotic pain medications such as codeine (for example, Tylenol #3), oxycodone (for example, Percocet), and hydromorphone (Dilaudid);
- Antidepressants such as amitriptyline (Elavil, Endep) and imipramine (Tofranil)
- Anticonvulsants such as phenytoin (Dilantin) and carbamazepine (Tegretol)
- Iron supplements
- Calcium channel blocking drugs (CCBs) such as diltiazem (Cardizem) and nifedipine (Procardia)
- Aluminum-containing antacids such as aluminum hydroxide suspension (Amphojel) and aluminum carbonate (Basaljel)
In addition to the medications listed above, there are many others that can cause constipation. Simple measures for treating the constipation (for example, increasing dietary fiber) caused by medications often are effective, and discontinuing the medication may not be not necessary. If simple measures don't work, it may be possible to substitute a less constipating medication. For example, a nonsteroidal ant-inflammatory drug or NSAIDs (for example, ibuprofen) may be substituted for narcotic pain medications, or one of the newer and less constipating antidepressant medications.
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