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Example sentences for: constipation
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Clozapine is a widely used atypical neuroleptic with affinity for multiple receptors, including dopamine, serotonin, alpha adrenergic, muscarinic and histaminergic receptors [ 1 2 ] . Although clozapine is effective in the treatment of schizophrenia refractory to traditional antipsychotic medication, it also has a number of significant side effects ranging from the potentially fatal but rare agranulocytosis to weight gain, constipation, seizures and urinary incontinence [ 3 ] . Urinary problems have been reported in the clinical literature with incontinence present in up to 44% of patients [ 4 ] and enuresis in 27% of patients [ 5 ] . Since clozapine has potent anti-muscarinic and anti-alpha adrenergic effects [ 2 ] , it has been proposed that peripheral effects on the lower urinary tract might be responsible for the micturition disturbances [ 6 ] . Incontinence has also been reported following therapy with other atypical neuroleptics such as risperidone [ 7 8 9 ] and recently, olanzapine [ 10 ] .
Olanzapine therapy is associated with a number of side effects, including somnolence, agitation, nervousness, headaches, dizziness, weight gain, constipation and dry mouth [ 5 ] . Olanzapine, however, does not produce extrapyramidal side effects, postural hypotension or hemotoxicity (a particular problem for patients on clozapine therapy [ 13 ] ). Although urinary retention as a result of olanzapine therapy may be predicted from binding studies due to olanzapine's antimuscarinic activity [ 12 ] only 1 case report of micturition disturbance associated with olanzapine has recently appeared [ 14 ] . On the other hand, several reports of urinary disturbances due to clozapine can be found in the clinical literature [ 3 10 15 ] .
Constipation should be expected during opioid treatment and prophylactic measures always be initiated from the outset as the condition is easier to prevent than treat [ 68 ] . Opioids cause constipation, but they are not the only medication to do so.
For most patients near the end of life, correction of the underlying pathophysiological cause of constipation is often not possible or appropriate.
Constipation is "the discomfort associated with reduced frequency of bowel movements" [ 67 ] . If left unmanaged, it can lead to abdominal pain, bloating, nausea and vomiting, overflow incontinence, tenesmus, fecal impaction, or even bowel obstruction.
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