Constipation Flashcards
1
Q
Causes of constipation
A
Hard faeces - low fibre, dehydration
IBS
Post op ileus
Obstruction - stricture, colorectal carcinoma, diverticulitis
Anorectal disease - fissures, prolapse
Endocrine - hypercalcaemia, hypothyroidism
Drug - opioid, iron tablets, anticholinergics
Spinal cord damage
Chronic laxative abuse
2
Q
Investigations
A
Exam for fissures and haemorrhoids DRE - hard stool do plain AXR, empty rectum do flexible sigmoidoscopy Hb TFTs Calcium
3
Q
Treatment for hard stool
A
Increase fluid intake
Consider long course of macrogol (osmotic laxative)
Faecal softener e.g docusate or glycerol
AVOID STIMULANT LAXATIVES - risk of perforation
4
Q
Treatment for soft stools
A
Stimulant laxative e.g phosphate enema acutely and senna long term