Constipation

Question 1

What common medications might impact adversely on bowel motions?

Answer 1

Opioids
Anticholinergics
Fe supplements
Calcium antagonists

Question 2

What are some causes of constipation in the elderly?

Answer 2

Comorbidities e.g. parkinsonism, DM, hypothyroidism
Immobility- slows peristaltic movement; ignoring the urge
Medications
Reduced fibre intake
Reduced fluid intake
Depression

Question 3

What examinations would you do on a person with constipation? Briefly describe why

Answer 3

PR- obstruction or constipation? anal tone and sensation
Neurological- spinal cord lesion, cauda equina
GI- bowel sounds slow or overactive, suprapubic dullness to percussion, palpate for masses

Question 4

How can might you manage an elderly person with constipation? For both soft and hard faecal impaction

Answer 4

Soft- bisacodyl
Hard- docusate arachis oil enema
Enemas- phosphate, Glycerin suppositories

Question 5

How might you manage a severely frail person with constipation?

Answer 5

Manual evacuation