Lecture 8: Abdominal Pain II Flashcards
What is the Rome Criteria for constipation?
Must have 2 symptoms over 3 months:
- Fewer than 3 bowel movements a week
- Straining
- Lumpy or hard stools: Types 1 and 2
- Sensation of incomplete defecation
- Manual maneuvering required to defecate
What are some concerning symptoms of constipation?
Rectal bleeding
Abdominal pain
Inability to pass flatus
Vomiting
What would be a thorough physical exam for a patient presenting with constipation?
Abdominal exam Anorectal exam Pelvic exam (females)
What can indicate constipation when doing an abdominal exam?
Distention or masses
Large abdominal hernias
What can indicate constipation when doing a pelvic exam?
Can palpate posterior vaginal wall and while straining can check for internal prolapse or rectocele
What can indicate constipation when doing an anorectal exam?
Perianal excoriation Skin tags/hemorrhoids Anal fissure Prolapse during straining Anorectal masses Tone of internal anal sphincter Presence of gross blood Presence of fecal impaction
What are some lifestyle modifications to improve constipation?
Increase water and fiber in diet
Use bathroom right away instead of “holding it”
Increase exercising
Schedule time for bowel movements
What is gastroenteritis?
Diarrhea accompanied by vomiting, nausea, or abdominal pain
- stomach flu
- mostly caused by viral infections
What two viruses are the most common cause of gastroenteritis?
Norovirus: seen in casinos and cruise ships
Rotavirus: contagious if not immunized
What parasite can also cause gastroenteritis?
Giardia
-mostly from infected waters
What drugs can cause diarrhea?
Antibiotics Laxatives Colchicine Quinidine Sorbitol PPI
How does IBS differ from IBD
Irritable Bowel Syndrome: disturbance in bowel function
Irritable Bowel Disease: destructive inflammation and permanent harm to the intestines
What are symptoms of IBS?
Altered bowel habits
Abdominal pain
Abdominal bloating/distention
What are some important questions to ask patients presenting with diarrhea?
Frequency/amount/color of bowel movements
Travel
Medication
What OS technique can improve constipation?
Mesenteric Release
-release the poo
