Constipation Depending Upon Diseases Of Other Organs

Numerous diseases of the stomach give rise to constipation. Foremost among these are hyperchlorhydria, ulcer and cancer of the stomach, ischochymia, atonic and catarrhal conditions of the stomach, and finally achylia gastrica - the last three, however, show a smaller percentage of this complication. In this group of cases constipation is attributable either to the abnormal qualities of the chyme passing through the digestive canal or to the retarded gastric prochoresis or to some retarding reflex act originating in the stomach.

Tumors of the intestinal canal or of neighboring organs compressing the bowel, strictures within the intestines, and peritonitic adhesions are also often associated with constipation. These conditions, moreover, frequently lead to a far more serious condition, namely, to acute or chronic ileus. Catarrhal inflammation of the small intestines alone is also ordinarily accompanied by constipation. Ulcers of the small intestine are sometimes attended by constipation. Ulcers of the large bowel are ordinarily accompanied by diarrhoea, excepting dysenteric ulcers, which often produce constipation. Fissure of the anus and an increased contraction of the sphincter of the anus are often causes of constipation.

In many diseases of the brain, spinal cord, and the nerves (cerebro-spinal meningitis, brain tumors, hemorrhages of the brain, chronic hydrocephalus, myelitis, tabes, neuroses and psychoses) constipation is present.

It is due here either to a disturbance of the nervous apparatus communicating with the centre for defecation, or to a diminished sensibility of the intestinal nerves so that stronger stimuli are required than under normal conditions.

Diseases of the lungs, heart, liver, and kidney increase the liability to constipation, first, by the hyperaemia of the intestinal mucosa, and, secondly, by the congestion in the portal circulation, which both retard the peristalsis-Diabetes mellitus often gives rise to constipation, first, by the polyuria which drains the organism of water and thus leads to an exsiccated condition of the fecal matter, and, secondly, by the diet, which consists principally of meat and of a very restricted quantity of starchy food. Diarrhoea, however, is not rarely met with in this disease.

Anaemia and chlorosis are also often attended by constipation. The latter is due to an atonic condition of the bowels, which is one of the symptoms of the general muscular atony dependent upon the impoverishment of the blood.

Most febrile diseases are also usually accompanied by constipation. Lack of exercise and an increased elimination of the fluids of the body caused by the greater activity of the lungs and the sudoriparous apparatus are the principal factors. Constipation encountered in people living in high altitudes must be ascribed, according to Ruedi,1 to the same causes. The restricted diet, consisting chiefly of milk, also contributes to a lessened activity of the intestinal peristalsis.