Constipation, Crohn's, IBD, UC Flashcards
What are some questions to ask about infrequent passage of stool?
How often?
How hard?
Is it painful?
Has there been a change?
What are some social reasons for constipation?
Poor diet
Insufficient fluids
Excessive milk
Potty training
What are some physical causes of constipation?
Intercurrent illness
Medication
What are some dietary steps to take in the treatment of constipation?
Increase fibre, fruit, vegetables and fluids
Decrease milk
How do we reduce some of the aversive factors in constipation?
Make going to the toilet a pleasant experience Correct height Not cold School toilets Soften stool and remove pain
What is an example of an osmotic laxative?
Lactulose
What is an example of a stimulant laxative?
Senna
Picosulphate
Give an example of an isotonic laxative?
Movicol
Laxido
What are some advantages to laxative use to soften stool and stimulate defecation?
Non-invasive
Given by parents
What are some disadvantages to laxative use to soften stool and stimulate defecation?
Non-compliance
Side effects
What is the usual dosage and frequency for laxatives?
Enough to make them go and to make sure stool always soft & never painful
Until no longer required
Related to duration of problem
How is severe constipation treated?
Empty impacted rectum Empty colon Maintain regular stool passage Slow weaning off treatment Ensure compliance
Is diarrhoea and rectal bleeding more indicative of Crohn’s or UC?
UC
Is weight loss and growth failure more indicative of Crohn’s or UC?
Crohn’s
Are arthritis, fever and abdominal pain more indicative of UC or Crohn’s?
About the same
What are some visible signs of Crohn’s or UC?
Oral changes
Perianal changes
Erythema nodosum
Is Crohn’s more common in paediatric or adult medicine?
Paediatric
Is UC more common in paediatric or adult medicine?
Adult
How does IBD incidence among sexes change between paediatric and adult medicine?
Adult - More common in females
Paediatric - More common in males
What are some diagnostic radiological investigations?
MRI
Barium meal and follow-through
What are some useful diagnostic endoscopy investigations?
Colonoscopy & Upper GI endoscopy
Mucosal biopsy
Capsule enteroscopy
Enteroscopy
What are the main aims of IBD treatment?
Induce and maintain remission
Correct nutritional deficiencies
Maintain normal growth and development
What kinds of medical treatment are used for IBD?
Anti-inflammatory
Immuno-suppressive
Biologicals ( Infliximab)
What is the first line treatment for Crohn’s
Polymeric diet
Oral prednisolone
