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Flashcards in Constipation & Diarrhea Deck (107)
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1

Define Constipation

Passage of stool infrequently or with difficulty
Stool frequency of less than three per week (straining, hard stool, incomplete evacuation)

2

Etiology of Constipation

Inadequate fiber in diet
Inadequate hydration
Inactivity

3

Medications that can cause Constipation

Opiates/narcotics
Antidepressants
CCB
Antipsychotic
Antiparkinsonian agents
Anticholinergics
Calcium, iron supplements
Antispasmodics
Antacids (calcium & aluminum)

4

Structural Abnormalities Causing Constipation

Carcinoma
Ischemia
Volvulus
Megacolon
Anorectal Disorders (prolapse, rectocele, pelvic floor dysfunction)

5

What is present with ischemia of the bowel?

Usually present with pain
Rebound tenderness

6

Pelvic Floor Dysfunction

ANS neuropathy
Pregnancy
Males with surgeries near the perineum

7

Metabolic Issues Causing Constipation

Hypokalemia
Hypomagnesemia
Hypothyroidism
Hyperparathyroidism
Porphyria- genetic hemoglobin disorder
Addison's disease
Hypercalcemia

8

Neurological Issues Causing Constipation

Parkinson's
MS
Automonic neuropathy
Hirschsprung disease
Chugs disease
Spinal cord lesions
Cerebrovascular disease

9

Hirschprung Disease

Myenteric plexus affected
Lack of cells at birth

10

Systemic Issues Causing Constipation

Amyloidosis
Scleroderma
Polymyositis
Pregnancy

11

Define Amyloidosis

Sclerotic fibers embedded in tissues

12

Define Scleroderma

Tightening of all outside tissue

13

Surgical Issues Causing Constipation

Abdominal
Pelvic
Colonic
Anorectal

14

Psychiatric Issues Causing Constipation

Depression
Eating disorders

15

Treatment of constipation in patients less than 50 years old with no alarm symptoms

Empiric treatment

16

Further treatment should be performed on patients with any of the following:

Over age 50
Severe constipation
Signs of an organic disorder
Hematochezia
Weight loss
Positive FOBT

17

Evaluation of Constipation

KUB
Barium enema
Colonoscopy
Blood Tests

18

Blood Tests for Constipation

Glucose
CBC
Thyroid
Calcium
Magnesium
Phosphorous

19

Define Colonic Transit Study

Observe transit time in patients with refractory constipation not responding to conservative measures

20

Management of Constipation

Prevention
Patient Education

21

Patient Education for Constipation

Exercise
Fluid intake
Fiber intake

22

What does exercise do for bowel movements?

Stimulus to colon peristalsis and defecation
Encourage and enable patient to be mobile

23

Fluid intake

Constipated stools are low in water content

24

Fiber intake

Acute constipation low on fiber diet
Chronic constipation responds poorly to fiber

25

Classes of Medications for Constipation

Stool softeners
Laxatives
stimulant laxatives
Opioid-receptor antagonist
Digital disimpaction

26

Types of Stool Softeners

Colace
Docusate calcium

27

Types of Laxatives

Bulk laxatives
Osmotics

28

Types of Bulk Laxatives

Psyllium
Methylcellulose
Fibercon (polycarbonophil)
Benefiber (wheat dextran)

29

Types of Osmotics

Lactulose
Sorbitol
Polyethylene glycol
Magnesium citrate
Magnesium sulfate

30

Types of Stimulant Laxatives

Bisacodyl
Senna