Constipation Flashcards
Constipation is defaecation that is unsatisfactory because of _____________ stools, difficult ________________, or seemingly ______________ defaecation
Infrequent
stool passage
incomplete
Constipation can occur at any age and is commonly seen in _____________, the _____________, and during ______________.
women
elderly
pregnancy
It is important for those who complain of constipation to understand that bowel habit can vary considerably in frequency without ______________
doing harm
*Some people erroneously consider themselves constipated if they do not have a bowel movement each day.
What are the red flags of constipation? (6)
- New onset
- Age > 50 years
- Accompanying anaemia or…
- Abdominal pain
- Weight loss
- Overt or occult blood in the stool
*these should provoke urgent investigation because of the risk of malignancy or other serious bowel disorders
In those patients with secondary constipation caused by a drug, the drug should be ___________.
reviewed
What is the lifestyle advice given to patients with constipation? (3)
Increase dietary fiber (gradually to minimize flatulence and bloating)
Adequate fluid intake
Exercise
If fiber is increased rapidly, it may lead to what symptoms? (2)
Flatulence
Bloating
The effects of a high-fibre diet may be seen in ___________ although it can take as long as ____________
a few days
4 weeks
Fruits high in ___________ and ___________, and fruit juices high in ___________, can help prevent and treat constipation
fibre
sorbitol
sorbitol
Misconceptions about bowel habits have led to excessive laxative use. Laxative abuse may lead to ______________
hypokalaemia
Before prescribing laxatives it is important to be sure that ____________________ and that __________________.
the patient is constipated
the constipation is not secondary to an underlying undiagnosed complaint
What are the different types of laxatives? (4)
- Bulk-forming
- Stimulant
- Stool softeners
- Osmotic
Bulk forming laxatives include…? (3)
- Ispaghula husk
- Methylcellulose (also acts as a stool softener)
- Sterculia
What must be maintained when taking laxatives to prevent bowel obstruction?
Adequate fluid intake
Bulk-forming laxatives are ideal in which patients?
Adults with small hard stools if fiber cannot be increased in the diet
Onset of action of bulk-forming laxatives is up to _____________
72 hours
_____________, ____________, and _____________ may be exacerbated by bulk-forming laxatives
Flatulence
Bloating
Cramping
Which drugs are offered as stimulant laxatives? (5)
- Bisacodyl
- Sodium pico sulfate
- Anthraquinones (senna, co-danthramer, co-danthrusate)
- Docusate sodium (stimulant and stool softener)\
- Glycerol suppositories (also softening effects)
What is the mechanism of action of stimulant laxatives?
Increase intestinal motility
What is the major side effect of stimulant laxatives?
Abdominal cramping
Stimulant laxatives should be avoided in cases of _________________
Intestinal obstruction
The use of co-danthramer and co-danthrusate is limited to constipation in ______________ patients because of potential carcinogenicity (based on animal studies) and evidence of genotoxicity.
terminally ill
The use of co-danthramer and co-danthrusate is limited to constipation in terminally ill patients because of potential _______________ (based on animal studies) and evidence of _____________.
carcinogenicity
genotoxicity
Docusate sodium is believed to act as both a ____________ laxative and as a ______________
stimulant
faecal softener