Medical history (history of illness) represents an important component in the diagnosis of constipation (constipation). Family history
- What is the general health of your relatives?
- Are there any diseases in your family that are common?
- Are there any hereditary diseases in your family?
Social history
- What is your profession?
- Are you exposed to harmful working substances in your profession?
- Is there any evidence of psychosocial stress or strain due to your family situation?
Current medical history/systemic history (somatic and psychological complaints).
- When did you last have a bowel movement?
- How regularly do you have bowel movements?
- Adults: less than 3 bowel movements per week?
- Children: two bowel movements per week or less?
- What does the bowel movement look like? Shape, color, odor, admixtures?
- Is the stool hard?
- Is there a need to push/push for the majority of bowel movements?
- Do you feel that defecation is complete?
- How severe was the constipation in the past 7 days?
- Do you use aids such as laxatives (laxatives) to have regular bowel movements?
- Do you have pain when you defecate? If so, for how long?
- Do you also suffer from abdominal pain? If so, for how long?
- Do you suffer from flatulence? If so, for how long?
Vegetative anamnesis incl. nutritional anamnesis.
- Are you overweight? Please tell us your body weight (in kg) and height (in cm).
- Are you underweight? Please tell us your body weight (in kg) and height (in cm).
- Have you lost body weight unintentionally recently? If so, how many kilograms in what time?
- What is your diet?
- Rich in fat and protein?
- Low in complex carbohydrates?
- Poor in dietary fiber
- How much do you drink daily (please specify in liters)?
- Do you like to drink coffee, black and green tea? If so, how many cups per day?
- Do you drink other or additional caffeinated beverages? If so, how much of each?
- Do you smoke? If yes, how many cigarettes, cigars or pipes per day?
- Do you drink alcohol more often? If yes, what drink(s) and how many glasses of it per day?
- Do you use drugs? If yes, which drugs (opiates resp. Opioids (alfentanil, apomorphine, buprenorphine, codeine, dihydrocodeine, fentanyl, hydromorphone, loperamide, morphine, methadone, nalbuphine, naloxone, naltrexone, oxycodone, pentazocine, pethidine, piritramide, remifentanil, sufentanil, tapentadol, tilidine, tramadol)) and how often per day or per week?
- Do you get enough exercise every day?
Self anamnesis incl. medication anamnesis
- Pre-existing conditions (diseases of the gastrointestinal tract, internal, neurological diseases, tumor diseases / cancer).
- Operations (abdominal surgical procedures).
- Radiotherapy
- Vaccination status
- Allergies
- Pregnancies
- Medication history
- Environmental history (lead?)
Medication history
- Activated charcoal
- Analgesics
- Opioid analgesics (opiates or opioids; morphine, oxycodone, piritramide, tramadol) → opioid-induced constipation (OIC).
- Antacids (aluminum hydroxide, calcium acetate, calcium carbonate, hydrotalcide, magnesium hydroxide, magnesium trisilicate).
- Antiarrhythmics
- Class IV antiarrhythmics (calcium channel blockers/calcium antagonists) – diltiazem, verapamil.
- Antibiotics
- Derivative of rifamycin (rifaximin)
- Anticholinergics (parasympath(ic)olytic) – biperiden, ipratropium bromide, metixen, oxybutynin, propiverin, scopolamine, tolterodine, trihexyphenidyl, trospium chloride.
- See also “Anticholinergic effects due to drugs” if applicable.
- Antidepressants
- Tricyclic antidepressants (amitriptyline, amitriptyline oxide, clomipramine, desipramine, doxepin, imipramine, opipramol, nortriptyline, trimipramine).
- Antidiarrheals (loperamide).
- Antiemetics
- Serotonin antagonists (dolasetron, granisetron, ondansetron, tropisetron).
- Antiepileptic drugs (valproic acid).
- Antihistamines (azelastine, clemastine, terfenadine).
- Antihypertensives (clonidine)
- Antiparkinsonian agents [anticholinergic or dopaminergic]
- Antipsychotics (neuroleptics) – clozapine
- Antisympathicotonics (alpha-methyldopa).
- Antitussives (codeine, dihydrocodeine, hydrocodone, noscapine).
- Barium sulfate as an oral radiographic contrast agent.
- Cholesterol absorption inhibitor (colestyramine).
- Diuretics [desiccation]
- Barium sulfate as an oral radiographic contrast agent
- Beta blocker
- Β-selective beta-blockers (acebutolol, atenolol, betaxolol, bisoprolol, celiprolol, metoprolol, nebivolol).
- Nonspecific beta blockers (oxprenolol, propranolol).
- Calcimimetic (Cinacelcet).
- Drug abuse
- Iron supplements
- Enzymes (pancreatin, porcine pancreatin preparations)
- HCV inhibitors – boceprevir
- Hormones
- Progestogens (dydrogesterone, etonogestrel, medrogestone, norgestrel, norethisterone, progesterone).
- GnRH analogs (buderelin acetate, goserelin acetate, leuporelin acetate, nafarelin acetate, triptorelin acetate).
- LH-RH analogues
- Immunosuppressants (thalidomide).
- Calcimimetics (Cinacelcet)
- Laxative abuse
- Lipid-lowering drugs
- Anion exchangers (colestipol, colestyramine).
- HMG-CoA reductase inhibitors (atorvastatin, fluvastatin, lovastatin, pravastatin, simvastatin).
- Monoaminooxidase inhibitors
- Monoclonal antibodies – pertuzumab, trastuzumab.
- IgG2 anti-RANKL antibody (denosumab).
- Proton pump inhibitors (PPI; acid blockers) – esomeprazole, lansoprazole, omeprazole, pantoprazole, rabeprazole.
- Sedatives (benzodiazepines).
- Spasmolytics (tolterodine, trospium chloride).
- Tuberculostatics (isoniazid).
Accompanying the examination, the affected person should keep a log for at least two weeks, documenting the frequency, consistency of the stool and any pain experienced during defecation.
