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5 Cards in this Set
- Front
- Back
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Define Constipation.
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*Presence of two or more of the following:
-Infrequent defecation < 2 times/ week -Straining more than 25% of time of defecation -Passage of hard stools -Sense of incomplete defecation -Use of manual maneuvers for evacuation |
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Enumerate causes of constipation.
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*General:
-Inadequate fiber intake -Immobility -Pregnancy *Metabolic/ Endocrinal: -Hypothyrodism -DM -Hypercalcemia *Drugs: -iron, calcium channel blockers, opiates *Functional: -Irritable bowel syndrome -Idiopathic slow transient time * Neurological: -Spinal cord lesions -Parkinson's disease *Psychological: -Repressed urge to defecate -Depression *GIT: -Intestinal obstruction. Pseudo obstruction *Colonic: -Cancer -Painful anal conditions -Divertricular syndrome *Obstructive constipation: -Pelvic floor dysfunction -Rectal prolapse |
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Give short notes on investigations for constipation.
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*Investigations to exclude general disease: CBC, renal function, thyroid function, serum calcium, blood glucose.
*To detect colonic disease: -Colonoscopy - Barium enema: better than colonoscopy as it detects mucosal lesions -Detection of colonic transient time (using radiolabelled markers) *To detect anorectal and pelvic floor dysfunction: -Anorectal manometry -Rectal ultrasonograpy *In case of neurological disease: MRI on cervical and dorsal spines |
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Give short notes on treatment of constipation.
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*Patient education about dietary and bowel habits
*Treatment of cause (hypothyrodism, irritable bowel syndrome, DM) *Slow transient constipation: increase fiber and fluid intake Severe cases: *Laxatives (4 types): -Osmotic: Lactulose -Bulk laxatives: Dietary fiber and wheat bran -Stimulatory: Senna -Softening: mineral oil *Suppositories: glycerol *Enema: olive oil *Surgery: in cases of -Obstructive causes -Anorectal lesions -Pelvic floor dysfunction |
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Constipation is a common complication in elderly. Why?
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*Decreased gastric acidity
*Decreased colonic motility *Decreased anorectal function |
