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Symptoms include abdominal pain which may come and go, vomiting, abdominal bloating, and bloody stool. [1] It often results in a small bowel obstruction. [1] Other complications may include peritonitis or bowel perforation. [1] The cause in children is typically unknown; in adults a lead point is sometimes present. [1]
Functional constipation, also known as chronic idiopathic constipation (CIC), is defined by less than three bowel movements per week, hard stools, severe straining, the sensation of anorectal blockage, the feeling of incomplete evacuation, and the need for manual maneuvers during feces, without organic abnormalities.
The water and stool may take some time to fully evacuate, especially with patients with obstructed defecation. People with reduced muscular strength of the anal sphincter may encounter problems with later leakage of the water mixed with stool, which may bring similar, socially devastating problems as seen with fecal incontinence.
Depending on the location of the volvulus, symptoms may vary. For example, in patients with cecal volvulus, the predominant symptoms may be those of small bowel obstruction (nausea, vomiting and lack of stool or flatus), because the obstructing point is close to the ileocecal valve and small intestine.
Common symptoms include abdominal pain, distension, and severe constipation. [12] Constipation occurs earlier and vomiting may be less prominent. Proximal obstruction of the large bowel may present as small bowel obstruction. [13] Patients may notice a history of bloating and narrowing of stools before the onset of more severe symptoms.
Voluntary withholding of the stool is a common cause of constipation. [17] The choice to withhold can be due to factors such as fear of pain, fear of public restrooms, or laziness. [17] When a child holds in the stool a combination of encouragement, fluids, fiber, and laxatives may be useful to overcome the problem. [36]
Symptoms may occur intermittently and over a prolonged period of time. It is not unusual for patients to present several times owing to the nonspecific nature of the symptoms. [ 4 ] Conditions and onset will vary if the disease is primary vs secondary and the underlying disease (if a secondary manifestation) and its management.
The signs and symptoms are variable, and in up to 25% of patients there may be no symptoms. [3] The most common signs and symptoms are bleeding, which can vary from minor to severe, rectal prolapse and incomplete evacuation (35%-76% of cases). [4]
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