L7: Constipation

Question 1

frequency of normal bowel movements

Answer 1

Question 2

Characters of constipated stool

Answer 2

• Over desiccated.
• Hard.
• Dry.
• Difficult to pass.

Question 3

Causes of Constipation

Answer 3

• Organic causes.
• Functional causes.

Question 4

Organic Causes of Constipation

Answer 4

Question 5

Functional causes of Constipation

Answer 5

• Alimentary constipation
• Medicaments caused constipation
• Laxative “addiction” constipation
• Proctogenic constipation (dyschezia)
• Symptomatic constipation
• Atonic constipation
• Inactivity Constipation

Question 6

Manifestations of Alimentary constipation

Answer 6

Dec stool weight or bulk.

Question 7

Causes of Alimentary constipation

Answer 7

lack of dietary fiber or liquids.

Question 8

Manifestations of Medicaments caused constipation

Answer 8

Decreased Propulsive activity.

Question 9

Causes of Medicaments caused constipation

Answer 9

Medications as

• Anticholinergic properties as antidepressants, antiarrhythmic drugs
• Opiates.
• Certain antacids.
• Calcium channel blockers.
• Laxatives.

Question 10

Causes of Laxative
“addiction” constipation

Answer 10

Defecation occurs only with use of a laxative.

Question 11

Manifestations of Laxative
“addiction” constipation

Answer 11

Habituation

Question 12

Causes of Proctogenic constipation (dyschezia)

Answer 12

• 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).

Question 13

Manifesations of Symptomatic constipation

Answer 13

• Appears as an additional symptom in many diseases which are not directly related to digestive system.

Question 14

Examples of Symptomatic constipation

Answer 14

• Hypothyroidism.
• Depression.
• Biliary & renal colic.
• Spinal cord diseases.
• Multiple sclerosis.

Question 15

Causes of Atonic constipation

Answer 15

impaired innervations of Auerbach plexus.

Question 15

Causes of Inactivity constipation

Answer 15

Decreased in physical activity (as illness forcing bed rest).

Question 16

Finding & Possible Cause

Constipation

Answer 16

Question 17

Alarm Signs & Symptoms of Constipation

Answer 17

Question 18

Def of Fecal Impaction

Answer 18

Question 19

Causes of Fecal Impaction

Answer 19

• Chronic constipation.
• Megacolon.
• Dolichocolon.
• Psychiatric conditions.
• Neurologic maladies.
• Medications (as cholinergic, codeine & methadone).
• Painful lesions of anal region (as hemorrhoids, anal fissure & prolapse).

Question 20

Clinical features of Fecal Impaction

Answer 20

• 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.

Question 21

Managment of Fecal Impaction

Answer 21

Question 22

tools in Manual removal of fecal impaction

Answer 22

Question 23

Procedure of manual removal of fecal impaction

Answer 23

Question 24

Def of **Enema**

Answer 24

Procedure of introducing liquids into rectum & colon via anus.

Question 25

Indications of **Enema**

Answer 25

Question 26

CI of **Enema**

Answer 26

- Bowel surgery "recent" - Colon ailments (Cancer, ulcers & diverticulitis) - Heart infarct "recent" - Arrhythmia "severe"

Question 27

MOA of **Enema**

Answer 27

Question 28

Types of **Enema**

Answer 28

Question 29

Equipment of **Enema**

Answer 29

Question 30

what are other used equipment while installing **Enema**?

Answer 30

* Bath thermometer. * Disposable gloves. * Water-soluble lubricant. * Waterproof, absorbent pads. * Toilet paper. * Wash basin. * Washcloths, towels & soap. * Bedpan, commode or access to toilet.

Question 31

Complications of **Enema**

Answer 31

- Tearing of rectal mucosa. - Perforation of rectum → Peritonitis. - Mucosa damage with inappropriate enema solution. - Circulation overload & electrolyte imbalance after too frequent use of enema.