Constipation

Question 1

constipation counselling structure

Answer 1

focussed hx/HPC
red flags
explain constipation & soiling
explain risk factors
reassure
lifestyle mx
med mx

Question 2

Red flags to consider in Constipation

Answer 2

Vomiting & abdo distension
Fevers
Loss of weight
ribbon stool
leg weakness

symptoms from birth?
meconium?
failure to thrive

Question 3

Explanation to parent what constipation => soiling is

Answer 3

Typically constipation is FUNCTIONAL which means there is no underlying cause

Lifestyle changes such as diet / water intake and movement all contribute to this. Stress, allergies (cow milk) & underlying disease

The soiling is caused by chronic constipation that leads to the rectum being desensitised to the detection of poo

This leads to soft poo moving around the hard poo and can cause this leakage (soiling)

Question 4

Use ATHLETIC to describe Movicol

Answer 4

A - Break up poo in tummy
T - 2 sachets a day
H - Powder in water drinks
L - until poo is watery
E - takes as long as it takes
T - N/a
I - Drink w/water dehydration
C - N/a

Question 5

HPC constipation

Answer 5

type of stool
blood in stool
pain
overflow diarrhoea
pushing hard?

Question 6

Reassure

Answer 6

very common 1 in 5
50% outgrow it in a year

Question 7

lifestyle mx constipation

Answer 7

good fibre/fluid intake
regular exercise
regular toileting - star charts: reward for sitting on toilet for 5 mins after breakfast & dinner // leave toys by toilet

Question 8

medication mx constipation

Answer 8

movicol –> + senna –> +lactulose