Adult - Constipation Flashcards
What is the beginning of constipation in adults?
3 stools per week or less
More prevalent in what population?
more in older women
Primary pathophys of constipation?
colorectal dysfunction
Secondary pathophys of constipation?
- neurogenic disorders (peripheral or central)
- IBS
- -medications* (antacids, stool softeners)
- non-neurogenic disorders
What are some peripheral neurogenic disorders that may cause constipation?
- diabetes**
- autonomic neuropathy
- intestinal pseudoobstruction
- chagas disease
- hirschprung disease
What are some central neurogenic disorders that may cause constipation?
- Multiple sclerosis
- spinal cordinjuries
- parkinson disease
What are some non-neurogenic disorders that may cause constipation?
- hypothyroidism
- hypokalemia
- anorexia nervosa
- pregnancy
- panhypopituitarism
- systemic sclerosis
- myotonic dystrophy
red flags to know when doing a patient work up:
History is super important -duh -RED FLAGS: hematochezia \+ fecal occult blood obstructive symptoms WL of 10 pounds or more change is stool caliber
Common drugs to watch for that cause constipation:
- antihistamines
- antispasmodics
- antidepressants
- antipsychotics
- iron supplements
- antacids
- opiates
- CCB
Constipation - Rectal exam - asses for:
hard stool masses anal fissures hemorrhoids sphincter tone BPH posterior vaginal mass
Blood tests with constipation:
CBC serum glucose creatinine calcium TSH
Suprising dietary solution for constipation?
prunes!
Usual best help for consitpation?
patient education - increase fiber and fluids - reduce laxative use (mess with electrolytes esp with stimulant laxative
