Constipation: Environment & Psychology

Environmental conditions

Simple constipation is a form caused by reduced food intake or a diet which does not include roughage, or the inhibition of the stimulus to evacuate induced by unfavorable environmental situations.

Constipation caused by incorrect beliefs: this term is applied to those patients who, without having a correct understanding of the normal frequency and modality of bowel movements, attribute the cause of their abdominal disturbances to “constipation”, in the absence of any functional alteration.

Dietetic constipation: reduction of food intake, and fibers in particular, is accompanied by a slowing of oro-anal transit and reduced evacuation frequency.

Psychological Alterations

Constipation caused by depression: chronic constipation is reported in a high percentage of patients affected by depressive psychosis11 and in the field of psychiatry it is believed that constipation can be a symptom of depression. This form of constipation is sometimes associated with that of colic inertia.

Constipation caused by anxiety: this may occur in patients presenting with difficulty in evacuating and a feeling of incomplete post-evacuative rectal emptying (20), and in patients with constipation caused by slowed transit through the colon (7).

Constipation caused by hypochondria: this term is applied to those patients who complain of having chronic constipation but in whom no functional alteration can be found.

Constipation caused by voluntary holding: healthy people can remarkably delay defecation and at the same time slow transit through the ascending colon and the recto-sigmoid tract (12). This type of mechanism often produces constipation in children which in some leads to constipation with megarectum-megacolon. This type of constipation -often learned in chidhood- can continue into adulthood as an acquired illness behavior (21).

Surreptitious constipation: this is when constipation is intentionally caused by the patient; it is synonym with constipation caused by voluntary holding.

Fictitious constipation: this is when the patient reports being unable to evacuate spontaneously, however, transit is normal and evacuation occurs at normal frequency and does not show any alterations.