| Theme |
Chronic Constipation : A New Classification, Pathophysiology, Diagnosis, Treatment |
| Title |
Cause and Measures of Secondary Constipation |
| Author |
Hidenori Ohkubo |
Department of Gastroenterology and Hepatology, Yokohama City University Hospital |
| Author |
Akiko Fuyuki |
Department of Gastroenterology and Hepatology, Yokohama City University Hospital |
| Author |
Atsushi Nakajima |
Department of Gastroenterology and Hepatology, Yokohama City University Hospital |
| [ Summary ] |
Secondary constipation is classified into symptomatic constipation which is secondary to some basic diseases and drug induced constipation which is caused by some specific drugs. Representative diseases causing constipation are endocrine diseases, neurological diseases, collagen diseases, hemodialysis due to renal failure, and psychiatric diseases. Drugs causing constipation include anticholinergic drugs, antidepressants, antiparkinsonian drugs, opioid analgesics, and diuretics. The main measures used to fight secondary constipation are treatment of primary diseases and discontinuation of these drugs ; however, these measures alone cannot adequately improve the symptoms. Hence, osmotic laxatives and secretory laxatives are necessary for almost all the patients with secondary constipation. Naldemedine, a peripherally acting μ‒opioid receptor antagonist, has been newly approved for opioid induced constipation (OIC) in 2017. Naldemedine is expected to improve both OIC symptoms and pain management in clinical practice by reducing the number of opioid withdrawal patients with OIC. |