L16: Constipation & Diarrhea Flashcards

1
Q

Def of Constipation

A
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2
Q

Incidence of Constipation

A

affects more than one in five of
The population

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3
Q

Causes of Constipation

A
  • Poor dietary and behavioral habits (the most common)
  • Structural abnormalities
  • Systemic diseases
  • Drugs
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4
Q

Causes of Constipation
- Poor dietary and behavioral habits (the most common)

A
  1. Low-fiber diet
  2. Decreased intake of fluids
  3. Ignoring desire of defecation
  4. Lack of exercise
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5
Q

Causes of Constipation

  • Structural Abnormalities
A
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6
Q

Causes of Constipation

  • Endocrinal Causes
A

hypothyroidism, diabetes mellitus & hyperparathyroidism

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7
Q

Causes of Constipation

  • Metabolic Causes
A

hypokalemia, hypercalcemia & uremia

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8
Q

Causes of Constipation

  • Neurological Causes
A

paraplegia, parkinsonism & multiple sclerosis

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9
Q

Causes of Constipation

  • Other causes
A

amyloidosis, scleroderma

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10
Q

Causes of Constipation

  • Drugs
A
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11
Q

Def of Refractory constipation

A

It includes patients without identifiable causes and who do not respond to conservative dietary management.

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12
Q

these patients can be divided into 2 categories:

A
  1. Colonic inertia (slow colonic transit)
  2. Outlet disorders
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13
Q

Characters of Colonic inertia

A

There is prolonged colonic transit time more than 72 hours (normal is 35 h)

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14
Q

Another Name of Colonic inertia

A

Chronic intestinal pseudo-obstruction

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15
Q

Causes of Colonic inertia

A
  1. Idiopathic: isolated to the colon or part of generalized disorder
  2. Psychogenic
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16
Q

Examples of Outlet disorders Causing refractory constipation

A

 Rectocele & rectal prolapse
 Rectal intussusception
 Anismus

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17
Q

These patients may complain of …..

A

excessive straining with sense of incomplete evacuation the need for digital pressure on the Vagina or perineum

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18
Q

Evaluation of a case of Constipation

A
19
Q

Investigations in Constipation

A
20
Q

Measurement of the colonic transit time in constipation

A
  • 24 radi0-opaque plastic markers are swallowed on 3 consecutive days.
  • An abdominal radiograph is taken on days 4 and 7, and the total number of markers remaining in the colon is counted.
21
Q

Defecography in Constipation

A

video study taken during straining and defecation.

22
Q

Alarm symptoms of Constipation

A
23
Q

TTT of Constipation

A
24
Q

Types of Laxatives used in Constipation

A
  • Osmotic laxatives: (Stool softeners)
  • Cathartic (Stimulant) laxatives
25
Q

Examples of Osmotic Laxatives

A

as lactulose, sorbitol & docusate sodium.

26
Q

SE of Osmotic Laxatives

A

They are safe and do not cause dependency.

27
Q

Examples of Cathartic (Stimulant) laxatives

A

bisacodyl, castor oil & Senna

28
Q

Uses of Cathartic (Stimulant) laxatives

A

They are used in acute constipation and may cause severe cramps & diarrhea

29
Q

SE of Cathartic (Stimulant) laxatives

A

Chronic use of these agents should be avoided and may result in loss of normal colonic neuromuscular function.

30
Q

Enemas in Constipation

A

by saline (non-irritating), tap water (irritating), or oil retention (Useful for hard or impacted stool) enemas.

31
Q

TTT of Colonic Inertia

A

Chronic use of enemas and cathartic agents.

32
Q

Psychiatric therapy in constipation

A

for patients with psychological disorders

33
Q

Surgical TTT of Constipation

A

for outlet obstruction & cancer

34
Q

Def of Dysentery

A

It means diarrhea associated with blood, mucous and tenesmus.

35
Q

Def of Tenesmus

A

Tenesmus means painful defecation with sense of incomplete evacuation

36
Q

Etiology of desentery

A
37
Q

CP of desentery

A
38
Q

Evaluation of desentery

A
39
Q

Sigmoidoscopy in ameobic dysentry

A

Flask shaped ulcers with intervening healthy mucosa

40
Q

Sigmoidoscopy in bacillary desentery

A

Diffuse inflammation with dirty yellowish pseudo membrane

41
Q

Sigmoidoscopy in Bilharzial dysentery

A

Polyps and ulcers

42
Q

TTT of dysentery

A
43
Q
A