Constipation/ IBS

Question 0

Differentiate btwn spastic and atonic constipation.

Answer 0

Spastic- hypertonicity of colon due to increased SNS response. Causes build up of toxins and irritation. Feces is loose and stringy.
Atonic- lack of tone in colon. Hard lumpy feces. Elderly, bedridden, resisting urge. Can also occur with cathartic colon or lazy bowel- too much reliance on laxatives and enemas

Question 1

Define constipation.

Answer 1

Slow, infrequent or difficult movement of feces through the bowel. Decreased motility of colon or difficulty in expelling stool.

Question 2

Which type of constipation is considered a medical emergency?

Answer 2

Obstructive- blockage of the colon

Question 3

What are the two functions of the colon?

Answer 3

1) recycling of nutrients

2) formation/ elimination of stool

Question 4

Where does the strongest absorptive capacity happen?

Answer 4

In the ascending colon

Question 5

What absorbs the majority of nutrients consumed, Along with most of bile salts and fluid?

Answer 5

The small intestine

Question 6

Where does bacteria help with nutrient recycling, water conservation, and metabolism?

Answer 6

In the ileal portion of the small intestine

Question 7

How is fibre relevant to the formation of stool?

Answer 7

Poorly fermented or indigestible decreases transit time. Easily digested fiber is completely digested, has little bulk and makes feces stay longer in bowels.

Question 8

What does the “fermentation chamber” refer to?

Answer 8

The cecum and ascending colon- it’s the place where bacteria is most active metabolically

Question 9

What is the storage and excretion of stool regulated by?

Answer 9

The ANS, PSNS increases peristaltic activity and inhibits rectum from releasing it’s contents. SNS do the opposite.

Question 10

Define peristalsis

Answer 10

An involuntary wave like movement which is induced reflexively by the distension of the walls of hollow tubes

Question 11

What is the difference Btwn peristalsis in the ascending colon and in the descending colon? What is the type of peristalsis that occurs after meals?

Answer 11

Ascending- anti peristalsis/ retrograde: towards cecum
Descending- tonic contractions, towards rectum. Separates contents.
Mass peristalsis- after meals, propulsive and retro pulsive contractions

Question 12

What are some of the rectal lesions that can cause constipation?

Answer 12

Haemorrhoids or perirectal abscess

Question 13

If there is constipation, what should you rule out through testing?

Answer 13

Appendicitis or bowel obstruction

Question 14

When is a rebound test indicated? What should you do if it is positive?

Answer 14

Lower right quadrant abdominal pain with low back pain, constipation for 3-4 days. If positive refer to emergency as it requires medical attention immediately.

Question 15

Define:

1) fecal impaction
2) mega colon
3) rectal prolapse

Answer 15

Fecal impaction- accumulation of dry fecal matter that can’t be expelled

Mega colon- dilated, atonic colon from chronic fecal obstruction

Rectal prolapse- eversion of rectal wall through anus

Question 16

What’s the difference in treatment if there is spastic constipation or atonic constipation?

Answer 16

Spastic- aim is to reduce SNS firing, relaxing, soothing

Atonic- need to mechanically move feces through bowel, brisker and more stimulating

Question 17

Name some medications that can cause constipation as a side effect

Answer 17

Antacids, diuretics, antihistamines, anaesthetics, antidepressants, iron supplements

Question 18

Define irritable bowel syndrome.

Answer 18

A disorder of motility in the small and large intestine resulting from digestive tracts reactions to daily stressors and dietary patterns. Pain, bloating and cramping from obstruction in flow of stool and gas.

Question 19

Comment on the severity of IBS and possible causes of it

Answer 19

Benign GI disorder that does not affect the intestinal tract, nutrient absorption or life span. Usually due to food intolerances or autonomic overreaction still stress.

Question 20

What is the most common GI disturbance in western society and what population is most likely to get it?

Answer 20

IBS, usually affects women more

Question 21

Where is pain usually located if it’s IBS? When is the pain worst? When is it usually relieved?

Answer 21

Pain in lower abdomen. Worst in a.m or after eating. Relieved by bowel movement

Question 22

What is halitosis and what digestive disorder is it associated with?

Answer 22

Bad breath- associated with IBS

Question 23

What sudden change in stool should be referred to a physician before treatment?

Answer 23

Sudden changes in bowel habits over 2 weeks or any change that might include blood (black, tar like stool)

Question 24

What are some essential oils that help relax client? Which ones can help promote release of gas?

Answer 24

Relax- chamomile, bergamot

Gas- peppermint, basil, fennel, lemon