Constipation Flashcards
Site
Associated pain
Quality
How frequently do you normally empty your bowels?
How frequently have you been going recently?
Has this pattern been consistent?
Do you find yourself straining when use the bathroom?
Do you feel any pain when empty your bowel?
Could you describe your stools?
What colour are your stools?
What is there consistency (i.e. hard and well formed or soft and poorly formed)?
Is there any blood in your stools (site of blood, colour, quantity)
Time course
How long have you had constipation for?
Did it start suddenly?
Has it been getting worse?
Has this ever happened before?
Context
What were you doing before the constipation started?
Have there been any changes to your diet?
Have there been any changes to your medication?
Relieving Factors
Is there anything that makes it better?
Have you tried taking anything to make it better?
Aggravating Factors
Normal
Associated Features
Have you noticed anything else with the constipation?
Have you noticed any pain, is it local or abdominal?
Do you feel like you are emptying your bowels?
Have you been taking any medication?
Have you been ill lately? Fever?
Have you experienced any weight gain or loss?
Has your appetite changed at all?
Have you noticed any blood in your stool?
Differential Diagnosis
Bowel Cancer – family history, past history, dark red blood in stools, weight loss, fever
Medication – current medication/ change in medication at time of onset
Diet – change in diet at time of onset
Hypothyroidism – Weight gain, insensitivity to cold, depression, loss of hair, neck enlargement, heavy periods
Parasitic Infection – Travel, migration, increased appetite, anaemia
What are we looking for in associated features?
Abdominal pain Rectal bleeding Anaemia Weight gain Insensitivity to cold Changes in mood Fever Changes in appetite
All
All
