constipation Flashcards
1
Q
constipation
A
- infrequent bowel motions less than 3/week
OR
- less often than normal or with difficulty, straining or in pain.
1
Q
constipation
causes
A
OPENED IT
- obstruction
> mechanical: adhesions, hernia, Ca inflammatory
> pseudo-obstruction: post-op ileus - pain
> anal fissure
> proctalgia fugax (sporadic pain) - endocrine/electrolytes
> hypothyroidism
> decreased Ca
> decreased K
> uraemia - neuro
> MS
> myelopathy (injury to the spinal cord), > cauda equina syndrome. - elderly
- diet/dehydration
- IBS
- toxins
> opiods
> anti-mACh
-
2
Q
constipation
management for less than three months
A
- treat underlying cause
> medication induced
> malignancy - diet & lifestyle
- laxatives or prunes/stool softeners
- evacuation measures
> enemas
> suppositories
> macrogols
> stimulant laxatives
> disimpaction
3
Q
constipation
management for more than three months
A
- treat underlying cause
- diet + lifestyle: fibre and water
- laxatives
> bulk: ispaghula or methylcellulose
> osmotic: lactulose, macrogols, magnesium citrate
> stimulant: senna, bisacodyl, sodium picosulphate
4
Q
bulking laxatives
mechanism
A
increases faecal mass –> increased peristalsis
5
Q
bulking laxatives
contraindications
A
- obstruction
- faecal impaction
6
Q
osmotic laxatives
mechanism
A
retain fluid in the bowel
7
Q
stool softeners
examples
A
docusate sodium (500mg daily)
8
Q
phosphate enema
indications
A
- constipation
- preparation for a flexible sigmoidoscopy
9
Q
suppository
examples
A
glycerol (stimulant)
10
Q
enema
procedure
A
- 1 hr before leaving home for day of examination
- place unopened enema bottle into jug of warm water for 5 mins.
- lie down on bed with knees to chest
- insert length of nozzle into your bottom, and squeeze bottle until it is empty.
- hold for 15 min until urge to open bowels.
