Constipation Notes Flashcards
Chronic constipation: There more stool forms and it backs up into the colon and there’s part of it that’s soft and there’s a large part that would get stuck and this could be impacted and it can cause an enlarged or dilated rectum and this is BAD!! Because it can lead to fissures and hemorrhoids
Normal poop:We want the stool to be moving along and passing along without incident
Constipation is less than ______ bowel movements per week, feeling as though they have gone to the bathroom but they didn’t completely go to the bathroom so bowel evacuation is incomplete…may also complain about decrease stool frequency…its not that they haven’t gone for 7 days but maybe they have gone but its been a really small amount and they also feel it has not been a complete evacuation
less than 3
Older adults greater than 65 are 5 times more likely to experience constipation than younger adults
Women are more than 3 times more likely to be affected than males . Constipation can also be frequent complaint in late pregnancy and after childbirth
Clinical presentation of constipation: difficulty passing the stool…bowel movement frequency will be different than there normal so again its their baseline and whats happening now and may complain of anorexia where they don’t want to eat anything,dull headache, low back pain, abdominal discomfort, bloating,gas, they may have psychosocial distress because its stressful when somebody is not regular and complaints of constipation
If someone is on long term opioid therapy they might need to be on laxatives long term
If someone is dehydrated and the person hasn’t been drinking water or meds cause constipation these are people who might need treatment with laxatives…encourage fluid intake in our pts which help to establish normal bowel function
Inadequate dietary fiber along with lack of fluid intake may contribute to constipation
Someone who hasn’t had a bowel movement for 10 days or 14 days needs to see the PCP
If pt has had constipation for less than 7 days we can treat them
Nonpharmacological therapy for constipation
Fruits and vegetables, fluid intake like water,fiber intake, females its 25g of fiber and males its 38g of fiber
With fiber intake if we give pt a lot of fiber off the bat it can cause a lot of GI problems and so we don’t want to do that…we want someone to start slowly and increase slowly so pt doesn’t have a lot of gas and uncomfortable bloating feeling associated with that increased fiber intake…Fiber increases stool weight, normalizes to one movement per day
__________ that is allowing enough time for somebody to go to the bathroom and have really quiet time so every morning when they wake up they have that set time 10 to 15 minutes that they are able to use the bathroom
undisturbed without rushing and they are not ignored there body’s sign or urgency of going to the bathroom
Bowel training is setting aside time that you regularly everyday go to the bathroom at this time and you are undisturbed
Bowel training
_____________ helps with normal body functions and increasing fluids can help with constipation
Adding fiber increases stool mass and normalizes that frequency of bowel movement so that’s why we want pts to eat fruits and vegetables
The longer stool is retained in the bowel the more water is absorbed out of the bowel contents and into cells leading to hard stool consistency and difficulty in passing this stool so we want to be hydrate and we want to have fruits and vegetables we want to keep things moving through the GI tract
Exercise
Pharmacologic Therapy for Constipation
Bulk forming, hyperosmotic, emollient,lubricant,saline, and stimulant
Bulk forming agents take a while to work. Most closely approximate physiologic mech on promoting evacuation…it most closely mimics what your body would actually be trying to do…it needs to be dissolved in _________BEFORE TAKING…this product stimulates trying to move stool through the GI tract and its not absorbed systemically and does not interfere with absorption of nutrients, onset is 12 to 24 hours so half a day to a day up to 72 hours so up to 3 days..this laxative can take a while to work but if someone is on a medication that is causing constipation and they need some long term therapy this one is perfectly safe to use everyday…many laxatives are NOT safe to use everyday but this one is safe to use regularly
You will separate medications by __________ but it may effect the absorption of some drugs and mix it with plenty of water pt would never take the powder by itself
water
two hours
Metamucil is used to feel less hungry Start with 1 serving per day gradually increase to desired daily intake…helps to keep a patient full longer…can be used to suppress appetite…lowers cholesterol to promote health…maintaining healthy blood sugar levels…fiber is going to help the body not to have blood pressure up when blood sugar spikes…promoting and maintain digestive health
