chronic constipation

Question 1

other signs/symptoms that go with constipation

Answer 1

poor appetite
irritable 
lack energy 
abdo pain/distension 
withholding or straining 

diarrhoea

Question 2

what is constipation

Answer 2

infrequent passing of stools

difficult to pass, hard, painful

Question 3

why do children become constipated

Answer 3

social: poor diet (insufficient fluids, excessive milk), potty training, school toilet
physical: intercurrent illness, medication

psychological (2ry)
organic

Question 4

viscous cycle

Answer 4

constipation - large hard stool - pain or anal fissure - withholding of stool - constipation

Question 5

treatment of constipation: social

Answer 5

explain rx to treatment

dietary

• fibre
• fruit
• veg
• fluids
• less milk

Question 6

treatment of constipation: psychological

Answer 6

make going to toilet a pleasant experience: correct height, not cold, soften stool and remove pain

avoid punitive behaviour from parents, reward good behaviour

Question 7

treatment of constipation: soften stool and stimulate defecation

Answer 7

osmotic laxatives (lactulose)

stimulant laxatives (senna, picosulphate)

isotonic laxatives (movicol, laxido)

Question 8

treatment of severe constipation

Answer 8

empty impacted rectum
empty colon 
maintain regular stool passage 
slow weaning off treatment
ensure compliance

Question 9

megarectum

Answer 9

big, dilated rectum due to large faecal mass

UTI

soiling

Question 10

1st line laxative choice

Answer 10

movicol