L16: Constipation & Diarrhea Flashcards
Def of Constipation
Incidence of Constipation
affects more than one in five of
The population
Causes of Constipation
- Poor dietary and behavioral habits (the most common)
- Structural abnormalities
- Systemic diseases
- Drugs
Causes of Constipation
- Poor dietary and behavioral habits (the most common)
- Low-fiber diet
- Decreased intake of fluids
- Ignoring desire of defecation
- Lack of exercise
Causes of Constipation
- Structural Abnormalities
Causes of Constipation
- Endocrinal Causes
hypothyroidism, diabetes mellitus & hyperparathyroidism
Causes of Constipation
- Metabolic Causes
hypokalemia, hypercalcemia & uremia
Causes of Constipation
- Neurological Causes
paraplegia, parkinsonism & multiple sclerosis
Causes of Constipation
- Other causes
amyloidosis, scleroderma
Causes of Constipation
- Drugs
Def of Refractory constipation
It includes patients without identifiable causes and who do not respond to conservative dietary management.
these patients can be divided into 2 categories:
- Colonic inertia (slow colonic transit)
- Outlet disorders
Characters of Colonic inertia
There is prolonged colonic transit time more than 72 hours (normal is 35 h)
Another Name of Colonic inertia
Chronic intestinal pseudo-obstruction
Causes of Colonic inertia
- Idiopathic: isolated to the colon or part of generalized disorder
- Psychogenic
Examples of Outlet disorders Causing refractory constipation
Rectocele & rectal prolapse
Rectal intussusception
Anismus
These patients may complain of …..
excessive straining with sense of incomplete evacuation the need for digital pressure on the Vagina or perineum