Chronic constipation Flashcards
1
Q
What is constipation - questions to ask
A
how often ?
how hard ?
is it painful ?
has there been a change ?
2
Q
Signs and symptoms with constipation?
A
Poor appetite Irritable Lack of energy Abdominal pain or distension Withholding or straining Diarrhoea
3
Q
why do children become constipated? - social
A
poor diet
Insufficient fluids
Excessive milk
potty training / school toilet
4
Q
why do children become constipated? other causes
A
intercurrent illness Medication dehydration - gaviscon, opiates physiological organic
5
Q
organic causes of constipation ?
A
normal time - eg during day or night
hypothyroidism
Hirschsprung disease
lead poisoning
6
Q
Treatment of constipation - social?
A
Explain treatment to parents
Dietary fibre fruit vegetables fluids less milk
7
Q
Treatment of constipation - Psychological
A
- Reduce aversive factors
- Make going to the toilet a pleasant experience
- Correct height
- Not cold
- School toilets
- Soften stool and remove pain
- Avoid punitive behaviour from parents
8
Q
treatment can involve
A
- Soften stool and stimulate defecation
- osmotic laxatives (lactulose)
- stimulant laxatives (senna, picosulphate)
- isotonic laxatives (Movicol / Laxido)
9
Q
megarectum can cause?
A
soiling and UTI
10
Q
Treatment of severe constipation
A
Empty impacted rectum - movicol, enemas, manual evactuation Empty colon Maintain regular stool passage Slow weaning off treatment Ensure compliance
