Constipation Flashcards
1
Q
Definition
A
Not uniform Characterised by Large stool size Infrequent bowel movements Firm consistency Delayed intestinal transit time Pain/discomfort on defecation Retentive posturing
2
Q
Organic causes
A
Neuromuscular dystrophy Morphine, codeine Anal atresia Hypothyroidism Prune belly syndrome Down's Gastroschisis Hirschprung's Tumour CP
3
Q
Diff dx
A
Infant dyschezia
Non-retentive faecal incontenince
4
Q
Colonic pathophysiology
A
R colon: desiccation of stool
L colon: further desiccation, rapid transport
Rectosigmoid: sensorimotor function
Functions regulated by neurotransmitters, intrinsic colonic reflexes and learned and reflex mechanisms
5
Q
Approach to constipation
A
History
Physical examination
Investigations
6
Q
Investigations
A
Laboratory for underlying AXR Barium enema (Hirschprung's) Radionucleotide scintigraphy Anal manometry
7
Q
Management
A
Education Disimpaction Maintenance therapy Behavioral modification - gastrocolic reflex Diet Treatment discontinuation
