Table 2.

Primary (Idiopathic) and Secondary Constipation

Primary (Idiopathic) Constipation
Normal-transit constipation : stool transit through the colon occurs at a normal rate, but patients report having difficulty evacuating the stool, or they report the presence of hard stools[2] Slow-transit constipation : delay in stool transit through the colon[1,24,25,27,28] Dyssynergic defecation (also known as pelvic floor dysfunction or dyssynergia): incomplete relaxation of the internal anal sphincter and the puborectalis muscle or inappropriate contraction of the external anal sphincter and the puborectalis muscle during defecation[1,2,27–29]
Secondary Constipation[7,10,20,23,26,27,30,31]
Medications (eg, opiates, anticholinergics, calcium channel blockers, antacids, calcium and iron supplements, antidiarrheals) Mechanical obstruction (eg, colon cancer, anal fissure or stenosis, hemorrhoids) Metabolic and endocrine conditions (eg, diabetes mellitus, hypothyroidism, hypercalcemia) Myopathies (eg, amyloidosis, scleroderma) Neuropathies (eg, Parkinson's disease, spinal cord injury, tumor)
Other conditions (eg, depression or anxiety, degenerative joint disease)