Constipation Flashcards
(8 cards)
1
Q
What are most cases of constipation described as?
A
Idiopathic constipation / functional constipation
Could be a behavioural issue.
2
Q
What are some secondary causes of constipation?
A
Hirschsprung disease, CF, hypothyroidism
3
Q
What could be some causes of constipation?
A
Toilet training, school toilets, diet/exercise
4
Q
What are some lifestyle factors contributing to constipation?
A
- habitually not opening the bowels
- low fibre diet
- poor fluid intake and dehydration
- sedentary lifestyle
- psychological problems eg. difficult home or school environment
5
Q
What are some red flags for constipation?
A
- if they’re constipated and not thriving
- from birth
- failure to thrive
- vomiting (intestinal obstruction, hirschsprung’s)
- not passed meconium (CF, hirschsprungs)
- abnormal lower back/buttocks
- any neurological symptoms/signs
6
Q
What is the presentation of constipation?
A
- < 3 stools a week
- hard stools that are difficult to pass
- rabbit dropping
- straining and painful passage of stools
- abdominal pain
- holding an abnormal posture = retentive posturing
- rectal bleeding with hard stools
- faecal impaction causing overflow soiling
- hard stools may be palpable in abdomen
- loss of sensation of the need to open bowels
7
Q
Why should you inspect the anus in cases of constipation?
A
To look for any infections, fissures, fistulas or bruising
Perianal group A streptococcal infection causes pain and erythema at the anus, which could cause constipation (treated with penicillin V).
8
Q
What is the management for constipation?
A
- correct any reversible contributing factors
- high fibre diet and hydration
- laxatives - macrogol laxatives (movicol), stimulate laxatives (senna)
- faecal impaction may need disimpaction regiment with high dose of laxatives
- encourage and praise visiting the toilet - scheduling visits, bowel diary and start charts
