Constipation
Infrequent or difficult bowel movements. Usually due to diet, fluids and medications — but the lab work-up rules out hypothyroidism, hypercalcaemia and kidney disease.
What it means
Constipation is defined by the Rome IV criteria as 2+ of: straining, lumpy or hard stools, sensation of incomplete evacuation, sensation of anorectal obstruction, manual manoeuvres needed for evacuation, fewer than 3 spontaneous bowel movements per week. Most cases are primary (functional) — diet, fluids, medications, sedentary lifestyle. Secondary causes include hypothyroidism, hypercalcaemia, diabetes (autonomic dysfunction), neurological disease (Parkinson's, multiple sclerosis), structural disease (colon cancer in older patients), and medications (opioids, anticholinergics, calcium channel blockers, iron supplements).
Common causes
- Diet and fluid intake — low fibre, low fluid, the dominant cause.
- Sedentary lifestyle — particularly hospitalised or bed-bound patients.
- Medications — opioids, anticholinergics, calcium channel blockers, iron, calcium supplements, antacids.
- Hypothyroidism — slowed motility plus other symptoms.
- Hypercalcaemia — primary hyperparathyroidism, malignancy.
- Diabetes — autonomic dysfunction.
- Pregnancy — progesterone-related slowing.
- Colon cancer — in older patients with new symptoms.
- Pelvic floor dysfunction — defaecatory disorder; specialised testing.
Lab work-up approach
Mediora interprets: TSH (hypothyroidism), calcium (hypercalcaemia), creatinine (kidney function affects laxative choice), HbA1c (diabetes), CBC (anaemia from chronic blood loss). Colonoscopy in older patients with new-onset constipation or warning features.
Tests Mediora.AI can interpret
Related conditions
When to see a doctor
Persistent constipation lasting more than 2 weeks despite lifestyle adjustment warrants a primary-care visit. Warning features needing urgent evaluation: blood in stool, unintentional weight loss, family history of colon cancer in a first-degree relative, change in bowel habits in someone over 50, anaemia. Most cases respond to fibre, fluids, exercise and short-term osmotic laxatives.