Constipation Flashcards
Causes of constipation
Idiopathic/functional
Hirschprungs
CF
Hypothyroidism
Typical features in history of constipation?
Less than 3 stools a week
Hard stools that are difficult to pass
Rabbit dropping stools
Straining and painful passages of stools
Abdominal pain
retentive posturing
Rectal bleed
Faecal impaction -> overflow soiling with incontence of particuarly loose smelly stools
Hard stools palpable in abdomen
Loss of sensation of need to open bowelsn
What os encopresis?
Faecal incontinence
When can encopresis be pathological?
over 4 years
What is encopresis a sign of?
Chronic constipation - rectum stretched and looses sensation
What happens in encopresis?
Large hard stools remain in rectum and only loose stools are able to bypass the blockage and leak out, causing soiling
Causes of encopresis
Spina bifida
Hirshcprungs disease
Cerebral palsy
Learning disbaility
Pscyhologcial stress
Abuse
Lifestyle factors contributing to constipation
Habitually not opening bowels
Low fibre diet
Poor fluid intake and dehydration
Sedentary lifestyle
Pscyhosocial problems eg difficult home or school environmeny - safeguarding
Secondary causes of constipation
Hirschprungs disease
Cystic fibrosis - meconium ileus
Hypothyroidis, m
Spinal cord lesions
Sexual abuse
Anal stenosis
Intestinal obstruction
Cows milk intolerance
Red flags in constipation
Not [assing meconium 24 hours after birth
Neurological signs or symptoms esp lower limbs
Vomitting
Ribbon stool
Abnormal anus
Abnormal lower back or buttocks
FTT
Acute severe abdo pain and bloating
Complications of constipation
Pain
Reduced sensation
Anal fissures
Haemorrhoids
Overflow and soiling
Psychosiocia morbidity
What can not passing meconium in 48 hours signal
Cystic fibrosis
Hirshcpru ngs disease
Neurological signs or symptoms with constopations suggest
Cerebral palsy
Spinal cord lesion
What does ribbon stool signal?
Anal stenosis
What can an abnormal anus signal?
Anal stenosis
IBD
Sexual abuse
