19. Constipation Flashcards

1
Q

What 4 main categories can you classify causes of constipation into ?

A

Abnormal peristalsis
Hard faeces
Bowel obstruction
Patient not pushing

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2
Q

What can cause abnormal peristalsis?

A

IBS

Medications- opiates, iron, calcium channel blockers

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3
Q

What can cause hard faeces?

A

Lack of fibre

Dehydration

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4
Q

What can cause bowel obstruction?

A

Colorectal adenocarcinoma

Sigmoid volvulus

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5
Q

What can cause the patient to avoid pushing when they go to the toilet?

A

Haemorrhoids, anal fissues, pelvic floor dysfunction

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6
Q

What are the red flags fro cosntipation?

A
  1. severe persistent constipation with no improvement on medication
  2. Absolute constipation with no gas passing
  3. Rectal bleeding, tenesmus, mucoid diarrhoea
  4. FLAWS
  5. PMHx UC/ Polyps
  6. FHx polyps/ cancer
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7
Q

What associated symtpoms should you ask about in someone with constipation?

A

Diarrhoea, tenesmus, blood, bloating, hypothyoidism symptoms, bone pains and polyuria

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8
Q

What may polyuria suggest in someone with constipation?

A

Hypercalcemia

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9
Q

What are risk factors for constipation?

A

History of bowel disease, endo/ neuro disease, back problems

FHx of bowel disorders

Poor diet

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10
Q

In what neurological conditions may patients have constipation as well?

A

Diabetic neuropathy, multiple sclerosis, cord compression or parkinsonism

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11
Q

What blood tests may be relevant in someone with constipation?

A

Full blood count- colonic mass can cause anaemia
Electrolytes anc alcium
TFTs

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12
Q

What are markers for colon cancer?

A

CEA, Ca 19-9

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