L7: Constipation Flashcards
frequency of normal bowel movements
Characters of constipated stool
- Over desiccated.
- Hard.
- Dry.
- Difficult to pass.
Causes of Constipation
- Organic causes.
- Functional causes.
Organic Causes of Constipation
Functional causes of Constipation
- Alimentary constipation
- Medicaments caused constipation
- Laxative “addiction” constipation
- Proctogenic constipation (dyschezia)
- Symptomatic constipation
- Atonic constipation
- Inactivity Constipation
Manifestations of Alimentary constipation
Dec stool weight or bulk.
Causes of Alimentary constipation
lack of dietary fiber or liquids.
Manifestations of Medicaments caused constipation
Decreased Propulsive activity.
Causes of Medicaments caused constipation
Medications as
- Anticholinergic properties as antidepressants, antiarrhythmic drugs
- Opiates.
- Certain antacids.
- Calcium channel blockers.
- Laxatives.
Causes of Laxative
“addiction” constipation
Defecation occurs only with use of a laxative.
Manifestations of Laxative
“addiction” constipation
Habituation
Causes of Proctogenic constipation (dyschezia)
- A suppression of normal defecatory rectal stimulus by voluntarily contracting external anal sphincter, Because of inconvenience or painful anal disease (as thrombosed hemorrhoid or anal fissure).
Manifesations of Symptomatic constipation
- Appears as an additional symptom in many diseases which are not directly related to digestive system.
Examples of Symptomatic constipation
- Hypothyroidism.
- Depression.
- Biliary & renal colic.
- Spinal cord diseases.
- Multiple sclerosis.
Causes of Atonic constipation
impaired innervations of Auerbach plexus.
Causes of Inactivity constipation
Decreased in physical activity (as illness forcing bed rest).
Finding & Possible Cause
Constipation
Alarm Signs & Symptoms of Constipation
Def of Fecal Impaction
Causes of Fecal Impaction
- Chronic constipation.
- Megacolon.
- Dolichocolon.
- Psychiatric conditions.
- Neurologic maladies.
- Medications (as cholinergic, codeine & methadone).
- Painful lesions of anal region (as hemorrhoids, anal fissure & prolapse).
Clinical features of Fecal Impaction
- Abdominal cramping & bloating.
- Leakage of liquid or sudden episodes of watery diarrhea “in someone has chronic constipation”.
- Rectal bleeding.
- Small, semi-formed stools.
- Straining when trying to pass stools.
- Bladder pressure or loss of bladder control.
- Lower back pain.
- Rapid heartbeat or light-headedness from straining to pass stool.
- Rectal exam will reveal a hard mass of stool in rectum.
Managment of Fecal Impaction
tools in Manual removal of fecal impaction
Procedure of manual removal of fecal impaction
Def of Enema
Procedure of introducing liquids into rectum & colon via anus.
Indications of Enema
CI of Enema
- Bowel surgery “recent”
- Colon ailments (Cancer, ulcers & diverticulitis)
- Heart infarct “recent”
- Arrhythmia “severe”
MOA of Enema
Types of Enema
Equipment of Enema
what are other used equipment while installing Enema?
- Bath thermometer.
- Disposable gloves.
- Water-soluble lubricant.
- Waterproof, absorbent pads.
- Toilet paper.
- Wash basin.
- Washcloths, towels & soap.
- Bedpan, commode or access to toilet.
Complications of Enema
- Tearing of rectal mucosa.
- Perforation of rectum → Peritonitis.
- Mucosa damage with inappropriate enema solution.
- Circulation overload & electrolyte imbalance after too frequent use of enema.
