Constipation & Diarrhoea Flashcards
Why is constipation more common in pregnancy?
Because there is slower movements of food through her intestines
What can cause constipation?
Lack of fibre
Low fluid intake
Sedentary lifestyle
Medications - opioids, antidepressants, Ca2+/iron supplements
Pregnancy
What is an anal fissure?
A small tear around the anus which ends up bleeding due to constipation
What are haemorrhoids (piles)?
A condition where the blood vessels around the anus become swollen and large, causing obstructions.
When do you refer a patient who is experiencing constipation?
If it has been for > 2 weeks
Pain on passing stool
Blood present
Suspected laxative abuse
Weight loss
N+V
What lifestyle advice can you give for someone experiencing constipation?
Increase fluid intake
Increase fibres - e.g. fruit/oats
Review medicines
Exercise
What are some examples of bulk forming laxatives?
Isphagula husk (fybogel)
Methylcellulose
Sterculia
How do bulk forming laxatives work?
They retain water in the gut to increase faecal bulk
What are some examples of osmotic laxatives?
Lactulose
Macrogol (movicol)
Sorbitol
How do osmotic laxatives work?
They increase water absorption in the colon and increase faecal
Which 2 types of laxatives are suitable for use in pregnancy?
Bulk-forming and osmotics
What are some examples of stimulant laxatives?
Senna
Bisacodyl
How do stimulant laxatives work?
They stimulate colonic nerves to increase intestinal motility
What time of the day are stimulants taken?
At night
Can you give stimulant laxatives in pregnancy?
No
What is a person as risk of if they frequently use stimulant laxatives?
Risk of fluid/electrolyte imbalances
What are some examples of stool softeners?
Docusate sodium
Glycerol
How do stool softeners work?
They reduce surface tension of contents by allowing fat/fluids to penetrate, emulsify & soften stools.
What causes diarrhoea?
Due to colon unable to absorb enough water/electrolyes, and causing the stool to pass too quickly
When do you refer someone who is experiencing diarrhoea?
Passing little urine
Cold hands/feet
Dry mouth
Other signs of dehydration
If they have recently travelled
<3 years old/elderly
Confusion/drowsiness
What is the 1st line treatment for diarrhoea?
Oral rehydration therapy - dioralyte sachets
Which condition should you avoid giving dioralyte to?
Diabetics, as it contains sugar
What age can dioralyte be given to?
Can be given to all age groups
How is loperamide given for diarrhoea?
4mg STAT, then 1 capsule after each loose stool
What is the max. amount of loperamide which can be taken in a day?
16mg (so 8 capsules max. /day)
What age group can you give loperamide to?
> 12 yrs old
