constipation Flashcards

1
Q

what is constipation?

A

when theres a reduction in normal bowel habit with more difficult defaecation and harder stools. occurs when large intestine reabsorbs more water than normal back into the bloodstream.

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2
Q

symptoms of constipation

A

abdominal discomfort, bloating, specks of blood due to straining.

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3
Q

causes of constipation

A

lack of fibre in diet,insufficient food intake, insufficient fluid intake, avoiding defaecation due to pain ( common in children), ignoring urge to defecate, lack of exercise, pregnancy, medications and ageing.

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4
Q

referral criteria for constipation

A

substancial blood loss, black and tarry stools, under 8, sudden change in bowel habits, pregnant women, longer than 7 days, other medications, no success of treatment after 5 days,frail or elderly,repeated abuse of laxatives

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5
Q

what is the purpose of stimulant laxatives?

A

they encourage bowel movements by acting directly on the wall of the intestine and stimulating peristalsis ( contractions of gi tract and organs).

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6
Q

how long do stimulant laxatives take to work?

A

between 8-12 hours so should be taken at night for expected bowel movements in the morning.

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7
Q

cautions for using stimulant laxatives?

A

long term use can lead to nerve damage and a lazy bowel. should be avoided in pregnancy as can cause contractions and it can cause gripping pain in abdomen.

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8
Q

types of stimulant laxatives

A

senna, bisacodyl, sodium picosulphate and glyceryl suppositories.

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9
Q

what is senna and the restrictions around use?

A

a natural stimulant laxative which provides a comfortable and predictable approach. its available as a syrup, tablets or granules and the usual starting dose is 7.5mg at night. its suitable for 12+

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10
Q

what is bisacodyl and the restrictions around use?

A

available as tablets or suppositories and recommended for over 10. can produce very thin and watery stools within 6-12 hours so recommended at night.

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11
Q

what is sodium picosulphate and the restrictions around use?

A

available as a liquid and and a solid form. can be given to 4+ on advice of a doctor

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12
Q

what are glyceryl suppositories and the restrictions around use?

A

effects can take place in 15-30 minutes. 1g for infants, 2g for children and 4g for adults. should be moistened before insertion.

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13
Q

what is the purpose of bulk forming laxatives?

A

increases volume of stool making it softer and easier to pass. patients should be advised to drink around 2l a day while taking.

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14
Q

how long do bulk forming laxatives take to work?

A

effects are usually seen in 12-36 hours although could take longer.

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15
Q

cautions around bulk forming laxatives?

A

gas, bloating and abdominal discomfort

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16
Q

types of bulk forming laxatives

A

iphagula husk, sterculia

17
Q

what is iphagula husk and the restrictions around use?

A

available as granules and powders taken with water. availale for 6+

18
Q

what is sterculia and restrictions around use?

A

available as granules placed in mouth and swallowed with water, can be sprinkled over food. available for 6+

19
Q

what is the purpose of osmotic laxatives?

A

osmotic laxatives turns the contents of the intestines into a stronger solution so it moves out the blood and into the gut so more water can pass through.

20
Q

types of osmotic laxatives?

A

lactulose, macrogol, magnesium salts

21
Q

what is lactulose?

A

concentrated sugar solution given twice daily. safe for children and usually takes 48 hours for full effects but can cause wind and abdominal cramps.

22
Q

what is macrogol and the restrictions around use?

A

polyethylene glycols are larger polymer molecules which combine with water keeping water in the bowel for longer. suitable for 12+

23
Q

what are magnesium salts and restrictions around use?

A

turns intestinal contents into a very strong solution causing water to move in the gut. can cause gas, bloating and abdominal pain and is not suitable for children.

24
Q

types of stool softeners

A

ducosate sodium

25
Q

what is ducosate sodium and the restrictions around use?

A

works by allowing fluid from the intestine to penetrate into the stool. also has some stimulant properties. only suitable for 12+

26
Q

what are the signs of laxative abuse?

A

very thin, pale clammy skin, dry and brittle hair, buying large amounts, dark circles around sunken eyes and malnourished appearance.