Panic attacks and paroxysmal hypertension in an elderly male patient manifesting during treatment for constipation

Abstract

An 81-year-old previously healthy man developed generalized fatigue, severe anorexia, and abnormal sensations throughout his body, along with paroxysmal hypertension, following an episode of constipation　and difficulty in　passing stools. A colonoscopy was performed, leading to a diagnosis of rectal mucosal　prolapse syndrome and colonic diverticulosis. The search for the cause of the paroxysmal hypertension　was negative for　pheochromocytoma. The patient’s recurrent symptoms were attributed to panic attacks　related to memories of difficult　bowel movements due to constipation. Supportive psychotherapy was　initiated. Four months later, he was hospitalized for diverticulitis. Interestingly, his panic attacks and　paroxysmal hypertension resolved after he was able to understand our explanation that his abdominal pain　was related to diverticulitis. This case highlights how a common symptom like constipation can　significantly impact mental health and overall well-being. This case also underscores the importance of　recognizing that frequent symptoms, such as constipation, can have a　substantial influence on both mental　health and physical functioning.