Constipation Flashcards
infrequent bowel movements or difficult passage of stools
constipation
how many BM constitutes constipation?
less than 3 BM per week
what can constipation lead to in the extremes of life (infants and elderly)? (2)
encopresis
aneurysm
soiling of clothing when impacted stool collects in the colon/rectum creating an overflow of liquid stool that leaks out
encopresis
what most often causes encopresis?
voluntary retention of stool
what is the treatment for encopresis? (2)
patience
positive reinforcement
what are 2 common primary etiologies of constipation?
slow colon transit (reduced motility of the large intestine)
defecatory disorders (impaired coordination of musculature during defecation)
what are 3 common secondary etiologies of constipation?
opiates
neuro, myopathies, electrolyte abnormalities
colon lesion/cancers (cause obstruction)
what are the 2 most common general etiologies of constipation?
inadequate fiber/fluid intake
poor bowel habits
what are 5 symptoms of constipation?
nausea +/- vomiting
bloated feeling
wave-like spasms
worse post-prandial
+/- bowel incontinence from overflow
what are 4 red flags of constipation?
new onset over 50 yo
bloody rectum/stools
weight loss
FHx of colon cancer or IBD
what physical finding will suggest that constipation has progressed to ileus?
hyperactive bowel sounds to hypoactive or absent bowel sounds
where will there be a palpable mass if a patient is constipated?
left side of abdomen
what physical exam is required for constipation?
DRE
what are 3 red flags during a physical exam?
systemic disease signs
severe abdominal tenderness, guarding, rebound
grossly bloody DRE, + FOBT, +FIT
