Constipation

Question 1

Risk factors for constipation

Answer 1

Advanced age, inactivity, low calorie intake, low fibre, medications, female sex

Question 2

Alarm features of constipation

Answer 2

Weight loss, abdominal mass, loss of appetite, dark stool

Question 3

Causes

Answer 3

Dietary, behaviour, elecrolyte disturbances, drugs, neurological disorders, endocrine disorders, colon disease

Question 4

Medication causes of constipation

Answer 4

Anti-depressants, anti-psychotics, levadopa, aluminium, iron, opiates

Question 5

Management of constipation

Answer 5

Exclude underlying causes, lifestyle medications, enemas, suppositories, bulk laxatives, stool softners, osmotic laxatives, stimulant laxatives, analgesia

Question 6

When are enemas used

Answer 6

If impaction is present

Question 7

When are bulk formers used

Answer 7

Colostomy, diverticular disease, IBS

Question 8

Eg of bulk formers

Answer 8

Unprocessed wheat bran or ispaghula husk, methycellulose, sterculia, polysaccharide polymers

Question 9

Eg of osmotics

Answer 9

Lactulose, macrogols, magnesium salts

Question 10

Eg of stimulants

Answer 10

Bisacodyl, dantron, senna

Question 11

Eg of faecal softners

Answer 11

Docusate

Question 12

What is post op ileus

Answer 12

Failure to pass flatus or faeces, bloating, distension, nausea, vomiting, absent bowel sounds

Question 13

Management of post op ileus

Answer 13

NBM, daily bloods, correct eletrolyte imbalances, encourage mobilisation, and reduce opiate analgesia