Constipation Flashcards
what is type of disorder is constipation
polysymptomatic heterogenous disorder
definition of constipation
unsatisfactory defecation characterised by infrequent stools, difficult stool passage, or defecation that is both infrequent and/or difficult.
aetiology/ causes of PRIMARY constipation
brain-gut neuroenteric functions might be compromised or due to IBS
aetiology of SECONDARY constipation
metabolic disturbances
medicines
neurological
primary colon diseases
what metabolic disturbances can lead to constipation
hypothyroidism, hypercalcaemia
which medicines can lead to constipation
antipsychotics, opiates and CCBs
which primary diseases of the colon can lead to constipation
anal fissures, strictures, cancer (SB obstruction e.g.)
presenting symptoms of constipation (history and exam)
inability to defacate
hard stools
infrequent stools
incomplete evacuation
excessive straining
risk factors for constipation
female and above 65
investigations
FBC, thyroid function tests, U&Es, blood glucose, AXR, barium enema
what can low or high TSH suggest with regards to a constipated patient
primary hypothyroidism if TSH High, secondary hypothyroid if TSH low
treatment
diet and lifestyle changes
laxatives and/or prunes and/or stool softeners
meds for bowel movement
movicol and senekot
diet and lifestyle advice to constipated patients
more water, more fibre, less straining. if calorie deficit, start eating more calories
