Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

PY6040 > Constipation and Diarrhoea > Flashcards

Constipation and Diarrhoea Flashcards

1
Q

Constipation Definition

A

Excessive straining, incomplete evacuation, failed/lengthy attempts of defecate, hard stools, less frequent number of stools per week

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Rome IV Criteria of Constipation

A 
Must include 2 or more of the following:
- Straining during defecation
- Lumpy or hard stools 
- Sensation of incomplete defecation
- Sensation of anorectal obstruction/blockage
- Manual maneuvers to facilitate
ALL OF THESE FOR MORE THAN 25%
- Fewer than 3 spontaneous bowel movements per week
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Mechanism of action

A
  • Food enters colon and it is liquid
  • Water is removed due to transverse, ascending and descending colons
  • Excessive water removal causes hard stools
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Aetiology of Constipation

A
  1. Lack of fibre
  2. Low fluid intake
  3. Sedentary lifestyle
  4. Pregnancy
  5. Medications
  6. Undiagnosed conditions
  7. Too much dairy
  8. Too much sugar and unhealthy fats
  9. Too much supplemental calcium and iron
  10. Out of balance gut bacteria
  11. Laxative abuse

More common in females, elderly, children and pregnant women

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Complications of constipation

A
  1. Anal sphincter muscles can weaker
  2. Anal fissures (tears caused by straining)
  3. Haemarrhoids(first degree/second degree/third degree piles
  4. Faecal and urinary incontinence
  5. Pelvic floor is weakened due to straining - may cause bloated feeling
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Symptoms of constipation

A

Abdominal discomfort, cramps, bloating, feeling of incomplete defecation, discomfort when passing stool, requiring manual assistance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

When to refer

A
  • Unexplained weight loss
  • Large amounts of blood in stool
  • Constipation with nausea and vomiting
  • Impacted
  • Laxative abuse suspected
    See GP if you have bowel cancer symptoms for more than 4 weeks
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Laxative abuse

A

Used to achieve weight loss

  • causes dehydration, electrolyte imbalance and mineral deficiencies
  • Long-term/permanent damage to digestive system
  • Chronic constipation
  • Damage to nerves and muscles of colon
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Lifestyle advice for constipation

A
  • Increase fluid intake (1.5-2L/day)
  • Increase physical activaty (150mins/week)(20 mins vigorous exercise)
  • Increase fibre intake (30g/day)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Fibre sources

A
  1. INSOLUBLE
    - pectans + beta glucans (fruits and oats)
    - Attracts water into stool making it softer and easier to pass
    - Promotes a healthier bowel
    - Insulin sensitivity (reduces diabetes)
  2. SOLUBLE
    - cellulose - wholegrain foods and nuts
    - 3g/day
    - Dissolves to create a gel and improves digestion
    - Reduces cholesterol, improves blood glucose and reduces diabetes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Bulk forming laxatives

A

ISPAGHULA, FYBROGEL, STERICULIA

  • Retains water in gut
  • Increases faecal bulk
  • Stimulate peristalsis
  • Onset of action = 12-24 hours
  • Side effects: Bloating, distention (abdominal pressure) and flatulence (passing of gas)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Osmotic Laxatives

A

LACTULOSE, MACRGOLS, MOVICOL

  • Increases water absorption in colon
  • Increases faecal bulk
  • Stimulates peristalsis
  • Onset of action = 4-48 hours
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Stimulant Laxatives

A

SENNA, BISACODYL

  • Stimulate colonic nerves
  • Increase intestinal motility
  • Stimulate peristalsis
  • Onset of action = 8-12 hours
  • Take at night, defecate in morning
  • Risk of fluid and electrolyte imbalance if used frequently
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Stool softeners

A

DOCUSATE SODIUM, GLYCEROL

  • Reduce surface tension
  • Increase penetration of intestinal fluid into faeces
  • Stimulate peristalsis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Prucalopride

A
  • Selective serotonin 5HT4 agonist
  • 2mg strength
  • When no other treatments have an effect
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Constipation in children

A

Preferred treatment: osmotic, stimulant and stool softener
Refer when:
- feeling weak, dizzy, marked anal pain, blood in stool

17
Q

Constipation in pregnancy

A

Preferred choice: Bulk forming and osmotic

  • Stimulant in 3rd trimester induces uterine contractions
  • Senna enters breast milk causing colic and diarrhoea in infants
18
Q

What is Diarrhoea

A

Stool has too much water to reabsorb

  • Lasts 5-7 days
  • Most infectious in the first 2 days
  • Wash hands and wash beddings seperately
  • Clean toilets, handles and surfaces frequently
19
Q

Aetiology of Diarrhoea

A
  • Bacteria
  • Virus - rotavirus
  • Protozoa and parasites
20
Q

Symptoms of diarrhoea

A
  • Watery stools
  • Abdominal cramps
  • Loss of appetite
  • Headache/fever
  • Associates with nausea and vomiting
21
Q

When to refer for diarrhoea

A

Symptoms of severe dehydration: drowsiness, confusion, dry mouth, sunken eyes, passing very little urine, cold hands and feet

22
Q

Referral period for diarrhoea

A

Babies = 24 hours
1-3 year olds = 48 hours
Adults = 3 days
Elderly = 48 hours

23
Q

Oral dehydration therapy

A 
DIAROLYTE
Fridge - 24 hrs
- Caution in diabetes ( high contents of sugar, salts, potassium )
- Adults = 1 -2 sachets
- Children = 1 sachet
- Under 2 = 1/2 sachet
24
Q

Anti-motility drug

A

LOPERAMIDE

  • Improves consistency of stool
  • Improves symptoms
  • Not licensed for OTC under 12 years
  • 2mg capsules
  • 2 capsules initially, then 1 capsule after each loose stool
  • Max. dose = 16mg/day
  • Susceptible to abuse (causes heart problems)
25
Q

Bismuth salicylate

A
  • For heart burn, indigestion and upset stomach
  • Over 16 years
  • Side effects: blackened stools and tongue
26
Q

Kaolin and Morphine

A

Kaolin absorbs water to bulk stool
Morphine slows gut motility
- Use over age of 12
- Potential to abuse

PY6040 (23 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions