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PCP > Diarrhoea & Constipation > Flashcards

Diarrhoea & Constipation Flashcards

1
Q

What is bowel habit?

A
  • the pattern of defaecation; or the mechanism by which the waste products of digestion are excreted by the body
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2
Q

Explain the process of digestion

A
  • Food is broken down mechanically –> chewing
  • Then broken into molecules –> chemicals such as stomach acid and pancreatic enzymes
  • Molecules are absorbed by small intentine and metabolised into energy
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3
Q

What happens to undigested material?

A
  • passes as a liquid effluent into the large bowel where fluid is extracted and the effluent is converted to faeces.
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4
Q

What is a normal frequency of defaecation?

A

one every 2-3 days to 2-3 times a day.

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5
Q

What should you ask about bowel habit?

A

Because the frequency of defaecation is so varied in the general population, always as about CHANGES IN BOWEL HABIT

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6
Q

What is diarrhoea?

A
  • diarrhoea denotes the frequent and excessive passing of watery unformed faeces
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7
Q

What is diarrhoea due to?

A
  • diarrhoea is usually due to damage to the lining of the bowel that inhibits absorption of water from the waste products of digestion
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8
Q

What are the three classifications of diarrhoea?

A
  • Acute, Progressive and Chronic
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9
Q

What is acute diarrhoea?

A
  • diarrhoea that has an abrupt onset and a short duration

- mostly lasts a few days and is usually caused by an infection such as gastroenteritis or food poisoning

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10
Q

What is persistent diarrhoea?

A
  • diarrhoea that lasts between 2 and 4 weeks
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11
Q

What is chronic diarrhoea?

A
  • diarrhoea that is slow to develop and has a long duration of longer than four weeks
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12
Q

With reference to diarrhoea, What cardinal features would you use when interviewing a patient?

A
  • Site of GI pain
  • Quality
  • Severity
  • Time Course
  • Context
  • R/A Factors
  • Associated Features
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13
Q

With reference to diarrhoea, What would you ask regarding Site?

A
  • Where is your abdominal pain?
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14
Q

With reference to diarrhoea, What would you ask regarding Quality?

A
  • How watery is it?
  • Blood?
  • Mucus?
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15
Q

With reference to diarrhoea, What would you ask regarding Severity?

A
  • Frequency?

- Volume of Stool?

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16
Q

With reference to diarrhoea, What would you ask regarding Time Course?

A
  • Acute vs. Chronic?

- Worsening over time?

17
Q

With reference to diarrhoea, What would you ask regarding Context?

A
  • Food?

- Travel overseas?

18
Q

With reference to diarrhoea, What would you ask regarding R/A Factors?

A
  • Better/worse?

- Tried anything to relieve it? Effect?

19
Q

With reference to diarrhoea, What would you ask regarding Associated Features?

A
  • Acute: nausea, fever, vomiting, other people sick

- Other: abdo pain, symptoms of dehydration, weight loss

20
Q

What is constipation? Due to?

A

Excessively hard stools usually caused by increase absorption of liquid as a result of slow transit through the large bowel

21
Q

What is constipation associated with?

A

Reduction in the frequency of defecation and a feeling of incomplete evacuation of the bowels

22
Q

What should you clarify is a patient is constipated?

A

Clarify exactly what they mean by the word constipation

23
Q

What are some causes of constipation?

A
  • low fibre diet
  • medications such as codeine
  • medical conditions
  • bowel cancer
  • immobility
  • hypothyroidism
24
Q

What is rectal bleeding?

A

Passage of blood or clots from the rectum

25
Q

What should you ask about with regards to rectal bleeding?

A

Amount of blood?

Colour?

26
Q

What can rectal bleeding be a sign of?

A
  • Haemorrhoids, anal fissure, colorectal cancer etc.

If there is blood in diarrhoea = can be inflammatory bowel disease

27
Q

How can you tell the origin of the blood in rectal bleeding?

A

The colour:
Bright Red = close to the anus
Darker/Maroon red= first regions of the large intestine
Black = upper GI tract

28
Q

What is the medical term for black stools?

A

Malaena

29
Q

What are black stools an indication of?

A
  • upper gastrointestinal bleeding
30
Q

What does upper GI bleeding manifest as?

A

haeatemesis, melaena or rarely rectal bleeding

31
Q

What should you enquire about if constipation or rectal bleeding are presenting?

A
  • family Hx of bowel cancer
32
Q

Why do the stools appear black?

A

Because the blood is oxidised by bacteria as it passes through the intestines.

33
Q

What are some useful ways to show that patient you are listening and understanding what they are saying to you?

A
  • repetition of what they are saying exactly?
  • Paraphrasing
  • Summarising

PCP (22 decks)

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