Bowel Disorder Drugs Flashcards
What is one of the most common GI disorders?
constipation
How is constipation diagnosed?
when bowel movements are associated with at least two of the following symptoms, occurring in the past three months with an onset of symptoms of at least six months (ROME IV DIAGNOSTIC CRITERIA)
What are the symptoms of ROME IV diagnostic criteria?
- Less than three spontaneous bowel movements per week
- Lumpy or hard stools from at least 25% of bowel movements
- Straining during at least 25% of bowel movements
- Manual maneuvers (such as digital stimulation, support of pelvic floor) to facilitate 25% of bowel movements
- Sensation of incomplete evacuation during at least 25% of bowel movements
- Sensation of anorectal obstruction or blockage during at least 25% of bowel movements
- Loose stools are rarely present without the use of laxatives
- Insufficient criteria for irritable bowel syndrome
Should everyone have the same bowel movements?
No, patients should have their OWN NORMAL bowel routine
What is a misconception about bowel movements?
that you need to go daily, or have consistency
What are examples of normal regular bowel movement patterns?
- some people might go daily
- some people might go once every 3 days
What are examples of normal irregular bowel movement patterns?
- some people may fluctuate depending on their diet, fluid and exercise patterns!
- perfectly healthy to have a bowel movement daily x 2 days, then not another again for 3 days!
How to assess bowel movement in patient?
- How many times do you go a week? Consistent Inconsistent?
- How is your fiber, fluid and exercise routine?
- In general, we recommend the three F’s:
- Fluids (2-3 Liters per day)
- Fibers (think of fruits, vegetables or BRAN!)
- Frequent exercise
- Did you start any new medications? (Anticholinergics, Opioids, Diuretics)
What are drugs to treat constipation?
- Magnesium Hydroxide
- Docusate Sodium
- Psyllium, Methylcellulose
- Senna, Bisacodyl
- Polyethylene Glycol, lactulose
(loosely defined as LAXATIVES)
What are some common uses for constipation drugs (laxatives)?
- Non-specific Constipation
- Opioid Induced Constipation
- Bowel Preparation for Colonoscopy
- Reduction of straining (patient after a surgery- someone who just gave birth, or someone with abdominal surgery, open heart surgery, etc.)
What are manifestations of a bowel obstruction?
- distended abdomen
- n/v
- abdominal cramping
- dehydration
- obstipation (not able to pass stool + gas)
What are adverse effects of constipation drugs (laxatives)?
- Avoid in bowel obstruction
- Diarrhea
- Electrolyte loss (strong laxative)
Why should you never take a laxative when having a bowel obstruction?
can cause a bowel perforation
What’s an indication for Docusate Sodium?
constipation
What is a nursing consideration/implication for Docusate Sodium?
Least likely to cause fluid + electrolyte loss
