Treatment of minor ailments – diarrhoea, constipation and haemorrhoids

Question 1

Question: Define diarrhea.

Answer 1

Answer: Diarrhea is the passing of watery stools more than three times a day.

Question 2

Question: Differentiate between acute and chronic diarrhea in terms of onset and duration.

Answer 2

Answer: Acute diarrhea comes on suddenly and lasts for five to 10 days, while chronic diarrhea persists for more than two weeks.

Question 3

Question: What happens in the large intestine during diarrhea that contributes to the watery consistency of stools?

Answer 3

Answer: In diarrhea, the large intestine becomes inflamed, preventing the normal process of fluid removal from food, resulting in watery stools.

Question 4

Question: What are the typical characteristics of stools during diarrhea?

Answer 4

Answer: Stools during diarrhea are watery and frequently passed.

Question 5

Question: Name some common symptoms associated with diarrhea.

Answer 5

Answer: Symptoms of diarrhea include abdominal cramps, flatulence, weakness, nausea, vomiting, fever, headache, and loss of appetite.

Question 6

Question: What potential complications can arise due to fluid loss during diarrhea?

Answer 6

Answer: Fluid loss during diarrhea can lead to dehydration and subsequent electrolyte loss, including sodium (Na+), potassium (K+), magnesium (Mg2+), and chloride (Cl-).

Question 7

Question: What are common causes of acute diarrhea?

Answer 7

Answer: Acute diarrhea is usually caused by a bacterial or viral infection, food poisoning or consumption of contaminated food or water, and it can also result as a side effect from some drugs.

Question 8

Question: What conditions or factors may contribute to chronic diarrhea?

Answer 8

Answer: Chronic diarrhea may be a symptom of more serious conditions such as Crohn’s disease, irritable bowel syndrome (IBS), and it can also be caused by the use of laxatives or a poor diet.

Question 9

Question: What is a primary recommendation for managing diarrhea without specific treatment?

Answer 9

Answer: Diarrhea often goes away after a few days without treatment.

Question 10

Question: How is dehydration prevented in the treatment of diarrhea?

Answer 10

Answer: Drinking fluids, including rehydration drinks, is recommended to prevent dehydration.

Question 11

Question: What type of foods are advisable to consume during and after diarrhea?

Answer 11

Answer: Eating foods high in carbohydrates is recommended during and after diarrhea.

Question 12

Question: Name a common anti-diarrhea medicine used to manage diarrhea.

Answer 12

Answer: Loperamide is a common anti-diarrhea medicine.

Question 13

Question: In addition to anti-diarrhea medicines, what other type of medication may be used to treat symptoms associated with diarrhea?

Answer 13

Answer: Painkillers may be used to treat symptoms such as fever or headache associated with diarrhea.

Question 14

Question: What is the primary function of rehydration drinks in the context of managing diarrhea?

Answer 14

Answer: Rehydration drinks can replace lost electrolytes but do not treat the diarrhea itself.

Question 15

Question: Provide examples of commercial rehydration products used for managing dehydration during diarrhea.

Answer 15

Answer: Commercial rehydration products include Dioralyte®.

Question 16

Question: Is it possible to prepare rehydration drinks at home, and why might someone choose to do so?

Answer 16

Answer: Yes, it is possible to make ‘home-made’ rehydration preparations. Some individuals may choose to do this for various reasons, including availability or preference for homemade solutions.

Question 17

Question: According to WHO recommendations, what is a ‘home-made’ rehydration solution?

Answer 17

Answer: According to WHO recommendations, a ‘home-made’ rehydration solution can be prepared by dissolving half a small spoon of salt and six level small spoons of sugar in one liter of water. Alternatively, lightly salted rice water is suggested.

Question 18

Question: How is Dioralyte typically prepared for consumption?

Answer 18

Answer: Dioralyte is a powder for reconstitution, and the directions recommend dissolving one sachet in 200ml of fresh drinking water. It should be consumed after each loose motion.

Question 19

Question: What are the main components of each Dioralyte sachet?

Answer 19

Answer: Each Dioralyte sachet contains:

• Sodium chloride: 470mg
• Potassium chloride: 300mg
• Disodium hydrogen citrate: 530mg
• Glucose: 3.56g

Question 20

Question: What form does the antidiarrheal come in, and what is the recommended method of preparation?

Answer 20

Answer: The antidiarrheal comes in powder form for reconstitution. To prepare, one typically dissolves each sachet in water.

Question 21

Question: What are the main components of each sachet of the antidiarrheal?

Answer 21

Answer: Each sachet of the antidiarrheal contains:

• Sodium chloride: 350mg
• Potassium chloride: 300mg
• Sodium citrate: 580mg
• Cooked rice powder: 6g

Question 22

Question: When should individuals experiencing diarrhea consider seeking medical attention or referral?

Answer 22

Answer: Individuals experiencing the following warning symptoms during diarrhea should seek medical attention or referral:

• Presence of blood or mucous in motions (bright red is okay in small amounts)
• Signs of dehydration such as lethargy, headache, and dry mouth
• Diarrhea lasting for more than five days
  Vomiting for more than one day
• High fever
• Recent change in bowel habit or recent travel abroad

Question 23

Question: Define constipation in terms of stool characteristics and frequency.

Answer 23

Answer: Constipation is characterized by the passage of hard stools (faeces) less frequently than the patient’s normal pattern.

Question 24

Question: Besides infrequent bowel movements, what is another characteristic associated with constipation?

Answer 24

Answer: Constipation is also characterized by the inability to completely empty the bowel.

Question 25

Question: What are some common symptoms associated with constipation?

Answer 25

Answer: Symptoms of constipation include:

• Change in stool frequency
• Stools can become unusually hard, lumpy, large, or small
• Stomach ache and cramps
• Feeling bloated, nauseous, loss of appetite
• Chronic problems, including hemorrhoids and fecal impaction

Question 26

Question: What lifestyle factor is associated with constipation and involves inadequate intake of fiber and/or fluids?

Answer 26

Answer: Constipation can be associated with a poor diet, specifically a lack of fiber and/or fluids.

Question 27

Question: How can a lack of mobility contribute to constipation?

Answer 27

Answer: Lack of mobility is a factor that can contribute to constipation.

Question 28

Question: Which medications, when taken, may contribute to constipation?

Answer 28

Answer: Medications such as antidepressants, antiepileptics, and iron supplements may contribute to constipation.

Question 29

Question: What physiological event related to reproduction can lead to constipation?

Answer 29

Answer: Constipation may occur during pregnancy.

Question 30

Question: Name some medical conditions that are associated with constipation.

Answer 30

Answer: Medical conditions such as diabetes, Parkinson’s, and an underactive thyroid are associated with constipation.

Question 31

Question: What lifestyle advice can be given for the treatment of constipation?

Answer 31

Answer: Lifestyle advice for treating constipation includes increasing fiber in the diet, adding bulking agents, increasing fluid intake, and enhancing daily exercise.

Question 32

Question: Name some types of laxatives that may be used in the treatment of constipation.

Answer 32

Answer: Laxatives used in the treatment of constipation include stimulant laxatives, bulk-forming laxatives, and osmotic laxatives.

Question 33

Question: What is the primary effect of stimulant laxatives on the intestines?

Answer 33

Answer: Stimulant laxatives increase intestinal motility.

Question 34

Question: What is the typical onset of action for stimulant laxatives, and when are they usually administered?

Answer 34

Answer: The onset of action for stimulant laxatives is 8-12 hours, and they are usually administered at night.

Question 35

Question: What are some potential side effects of stimulant laxatives?

Answer 35

Answer: Side effects of stimulant laxatives include abdominal cramps, excessive fluid loss, and electrolyte imbalance.

Question 36

Question: Can you provide examples of stimulant laxatives?

Answer 36

Answer: Examples of stimulant laxatives include senna and bisacodyl.

Question 37

Question: How do bulk-forming laxatives stimulate peristalsis, and what is their mode of action in relation to dietary fiber?

Answer 37

Answer: Bulk-forming laxatives stimulate peristalsis in a similar way to dietary fiber.

Question 38

Question: What is the typical onset of action for bulk-forming laxatives?

Answer 38

Answer: The onset of action for bulk-forming laxatives is 24-36 hours.

Question 39

Question: Why is it important to drink plenty of water when using bulk-forming laxatives?

Answer 39

Answer: It is important to drink plenty of water when using bulk-forming laxatives to avoid impaction.

Question 40

Question: What are some potential side effects of bulk-forming laxatives?

Answer 40

Answer: Side effects of bulk-forming laxatives include flatulence and abdominal bloating.

Question 41

Question: Can you provide examples of bulk-forming laxatives?

Answer 41

Answer: Examples of bulk-forming laxatives include bran and ispaghula husk.

Question 42

Question: How do osmotic laxatives work in the bowel, and why is it important to drink plenty of fluids when using them?

Answer 42

Answer: Osmotic laxatives retain fluid in the bowel by osmosis, and it is important to drink plenty of fluids to support their effectiveness.

Question 43

Question: What is the typical onset of action for osmotic laxatives?

Answer 43

Answer: The onset of action for osmotic laxatives is up to 3 days.

Question 44

Question: What are some potential side effects of osmotic laxatives?

Answer 44

Answer: Side effects of osmotic laxatives include flatulence, abdominal pain, and colic.

Question 45

Question: Can you provide examples of osmotic laxatives?

Answer 45

Answer: Examples of osmotic laxatives include lactulose and magnesium salts.

Question 46

Question: When should individuals experiencing constipation consider seeking medical attention or referral?

Answer 46

Answer: Individuals experiencing constipation should seek medical attention or referral if they experience:

• Constipation alternating with diarrhea
• Presence of blood or mucous in motions (bright red is okay in small amounts)
• Unexplained weight loss
• Abuse of laxatives
• Vomiting
• Fever
• Angina

Question 47

Question: What role do anal vascular cushions play in the maintenance of continence?

Answer 47

Answer: Anal vascular cushions assist the anal sphincter in maintaining continence.

Question 48

Question: How would you define hemorrhoids in terms of their anatomy and function?

Answer 48

Answer: Hemorrhoids are defined as the abnormal swelling or enlargement of the anal vascular cushions.

Question 49

Question: What is the prevalence of hemorrhoids in the population based on self-reporting?

Answer 49

Answer: The prevalence of hemorrhoids is reported to be between 13-36% of the population, and it’s worth noting that many anorectal symptoms are often wrongly attributed to hemorrhoids.

Question 50

Question: What is a common symptom of hemorrhoids related to rectal bleeding, and how is it characterized?

Answer 50

Answer: A common symptom of hemorrhoids related to rectal bleeding is bright red rectal bleeding, where blood is seen on the surface of the stool and not mixed in.

Question 51

Question: What is pruritus, and how is it related to hemorrhoids?

Answer 51

Answer: Pruritus, or itching, is a symptom of hemorrhoids due to chronic mucus discharge and irritation.

Question 52

Question: How can impaired continence or mucus discharge manifest as a symptom of hemorrhoids?

Answer 52

Answer: Soiling is a symptom of hemorrhoids due to impaired continence or mucus discharge.

Question 53

Question: What are some sensations or physical symptoms that individuals with hemorrhoids may experience?

Answer 53

Answer: Individuals with hemorrhoids may experience rectal fullness or an anal lump.

Question 54

Question: What can happen to large prolapsed hemorrhoids, and how is it characterized?

Answer 54

Answer: Large prolapsed hemorrhoids can thrombose, leading to a very painful purple/blue, oedematous, tense, and tender perianal mass.

Question 55

Question: What is a common cause of hemorrhoids related to excessive straining?

Answer 55

Answer: Excessive straining, often resulting from chronic constipation, is a common cause of hemorrhoids.

Question 56

Question: How does increasing age contribute to the development of hemorrhoids?

Answer 56

Answer: Increasing age is a factor that can contribute to the development of hemorrhoids.

Question 57

Question: Name some conditions or situations that can lead to raised intra-abdominal pressure and contribute to hemorrhoids.

Answer 57

Answer: Conditions or situations that can lead to raised intra-abdominal pressure and contribute to hemorrhoids include pregnancy, chronic cough, ascites, and less commonly, pelvic/abdominal masses, family history, cardiac failure, or portal hypertension.

Question 58

Question: What is an important aspect of the treatment of hemorrhoids that should be addressed?

Answer 58

Answer: Treating constipation is an important aspect of the treatment of hemorrhoids.

Question 59

Question: What role do creams, ointments, and suppositories play in the treatment of hemorrhoids?

Answer 59

Answer: Creams, ointments, and suppositories are used in the treatment of hemorrhoids to alleviate symptoms, but they do not cure the condition.

Question 60

Question: What are some components commonly found in creams for hemorrhoid treatment?

Answer 60

Answer: Creams for hemorrhoid treatment may contain local anesthetic, astringent, and barrier cream.

Question 61

Question: What is the typical duration of short-term treatment for hemorrhoids using creams, ointments, and suppositories?

Answer 61

Answer: Short-term treatment with creams, ointments, and suppositories usually lasts for 5-7 days.