- Meds: narcotics, anti-cholinergics, many others that affect motility, stool consistency
- Poor intake of liquids, fiber
- Older age is associated with most of the above issues
- Need to obtain accurate history of onset, frequency BMs, stool consistency, diet, activity level, liquid intake
- Constipation is often chronic
- Assess for temporal connection between constipation and medication (if related), immobility (if related), cognitive decline (if related), etc.
- Assess for any symptoms that suggest another underlying process (e.g. endocrinopathy, colonic structural disorder--> cancer, etc.)
- Assess for other contributing processes: neurological disease, cognitive impairment, peri-rectal disease, stool impaction, mechanical obstruction, etc.
- Labs, imaging, and endoscopy as indicated by history, RFs, exam to rule out other contributors