ABSTRACT
Constipation is the complaint of difficult defecation. It may be caused by the following mechanisms: mechanical bowel obstruction; impaired neurological control of bowel motility; toxic, endocrine or metabolic derangements resulting in reduced bowel motility; and lifestyle factors or functional disorders. Absolute constipation and urgent surgical referral is mandatory. Change in bowel habit in association with low back pain may be due to cauda equina syndrome, which is a neurosurgical emergency. If this condition is suspected, an urgent Magnetic resonance imaging (MRI) of the spine should be performed and a neurosurgical review arranged. Lower spinal cord pathology may cause spastic paraparesis or loss of lower limb sensation. Cauda equina syndrome is associated with flaccid lower limb weakness and loss of lower limb sensation. MRI of the spine should be performed urgently if spinal cord pathology or cauda equina syndrome is suspected.
