Constipation and Diarrhoea

Question 1

Describe constipation

Answer 1

• twice a week or less and straining involved when passing stool.
• Caused by poor diet, low fluid intake, disease or drugs

Question 2

Describe the management of constipation

Answer 2

Non-drug - 1st line
- increase fluid (2L a day) and increase fibre
Drug treatment - laxatives
- Bulk forming
- Stimulant
- Osmotic Faecal softener

Question 3

Bulk forming

Answer 3

• Increases the size of stool -retain fluid
• Increase size stimulates peristalsis
• Increase fluid intake
  *Safe in pregnancy
  EXAMPLE: ispaghula

Question 4

Stimulant laxatives

Answer 4

• Stimulate colonic nerves - causes movement of stool
  *Not safe in pregnancy
  EXAMPLE: Senna, Bisacodyl

Question 5

Osmotic

Answer 5

• Salts retain fluid in the bowel using osmosis
• Should increase fluid intake
  EXAMPLE: Mg salts, Lactulose, PEG
  *Avoid in Pts with renal issues

Question 6

Softeners

Answer 6

• Surfactants will decrease surface tension
• Allows the passage of water and lipids into the stool mass
  *Not for haemorrhoid pts

Question 7

Describe diarrhoea

Answer 7

• Passage of loose or watery stool
• Usually due to infection
• Can be drug induced
• IBS can be cause

Question 8

What are the treatment pathways for diarrhoea?

Answer 8

1. Increase fluid and electrolyte intake
2. Anti-motility drugs
3. Antibiotics

Question 9

Describe anti-motility drugs in regards to diarrhoea

Answer 9

Loperamide (imodium)
- Synthetic opioids binds to mu opioid receptors in the gut
- Decrease peristalsis, increase transit time
- Increase water and electrolyte reabsorption