Constipation

Question 1

What is the pertinent anatomy regarding constipation?

Answer 1

Large intestine(Cecum and rectosigmoid), rectum, and anus.

Question 2

What is the pertinent physiology regarding constipation?

Answer 2

Most common digestive complaint in the US. Consists of sensory and motor functions.
When sensory inputs are received more water is absorbed from fecal material. Defecation consists of coordinated colonic peristalsis, rectal contraction, and early anal relaxation.

Question 3

What is the pathophysiology of constipation?

Answer 3

Low intake of fiber, decreased fluid intake, systemic disease, medications, structural abnormalities, slow colonic transit, irritable bowel syndrome, and Hirschprung disease.

Question 4

What are the symptoms of constipation?

Answer 4

Infrequent bowel movement, excessive training, sense of incomplete evacuation, and may need digital manipulation.

Question 5

How do you treat fecal impaction?

Answer 5

Manual disimpaction.

Question 6

How do you treat constipation?

Answer 6

Adverse psychosocial issues should be addressed.

First line includes strict dietary changes and exercise, increased water intake and fiber supplementation.

Question 7

What is the dosage for docusate and bisacodyl?

Answer 7

100 mg for docusate
5-15mg for bisacodyl