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Secondary (Organic) Constipation Dietary: Low fiber, dehydration Medications: Opioids, anticholinergics, calcium channel blockers, iron supplements Metabolic / Endocrine: Hypothyroidism, diabetes mellitus, hypercalcemia Neurological: Parkinsons disease, spinal cord injury, multiple sclerosis Obstruction: Colorectal cancer, strictures, volvulus Psychogenic: Depression, eating disorders Clinical Features Infrequent bowel movements ( 50) Anorectal manometry or transit studies (if chronic functional constipation) Management 1