Case continued:
Lab Data: hematocrit 33 (MCV 84); white count 9,000; platelets 178,000
Na+ 133, K+ 3.3, Cl+ 99, CO2 25, BUN 35, Creat 1.6, glucose 82, calcium 10.1, albumin 3.2
Liver function tests normal except, notable for alkaline phosphatase +200, AST 77 (0-35) and ALT 60 (0-35).
Amylase./ lipase normal
Chest x ray: atelectasis left base.
CT abdomen/ pelvis: Impression - local progression of pancreatic cancer compared with a scan 2 months ago, several masses in liver (largest 13 mm) unchanged from previous scan, no hepatic ductal dilatation and abundant stool throughout the colon without obstruction.
Consider what are 3 potential causes of Mr. M’s constipation?