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Flashcards in Diarrhoea & Constipation Deck (33):
1

What is bowel habit?

- the pattern of defaecation; or the mechanism by which the waste products of digestion are excreted by the body

2

Explain the process of digestion

- Food is broken down mechanically --> chewing
- Then broken into molecules --> chemicals such as stomach acid and pancreatic enzymes
- Molecules are absorbed by small intentine and metabolised into energy

3

What happens to undigested material?

- passes as a liquid effluent into the large bowel where fluid is extracted and the effluent is converted to faeces.

4

What is a normal frequency of defaecation?

one every 2-3 days to 2-3 times a day.

5

What should you ask about bowel habit?

Because the frequency of defaecation is so varied in the general population, always as about CHANGES IN BOWEL HABIT

6

What is diarrhoea?

- diarrhoea denotes the frequent and excessive passing of watery unformed faeces

7

What is diarrhoea due to?

- diarrhoea is usually due to damage to the lining of the bowel that inhibits absorption of water from the waste products of digestion

8

What are the three classifications of diarrhoea?

- Acute, Progressive and Chronic

9

What is acute diarrhoea?

- diarrhoea that has an abrupt onset and a short duration
- mostly lasts a few days and is usually caused by an infection such as gastroenteritis or food poisoning

10

What is persistent diarrhoea?

- diarrhoea that lasts between 2 and 4 weeks

11

What is chronic diarrhoea?

- diarrhoea that is slow to develop and has a long duration of longer than four weeks

12

With reference to diarrhoea, What cardinal features would you use when interviewing a patient?

- Site of GI pain
- Quality
- Severity
- Time Course
- Context
- R/A Factors
- Associated Features

13

With reference to diarrhoea, What would you ask regarding Site?

- Where is your abdominal pain?

14

With reference to diarrhoea, What would you ask regarding Quality?

- How watery is it?
- Blood?
- Mucus?

15

With reference to diarrhoea, What would you ask regarding Severity?

- Frequency?
- Volume of Stool?

16

With reference to diarrhoea, What would you ask regarding Time Course?

- Acute vs. Chronic?
- Worsening over time?

17

With reference to diarrhoea, What would you ask regarding Context?

- Food?
- Travel overseas?

18

With reference to diarrhoea, What would you ask regarding R/A Factors?

- Better/worse?
- Tried anything to relieve it? Effect?

19

With reference to diarrhoea, What would you ask regarding Associated Features?

- Acute: nausea, fever, vomiting, other people sick
- Other: abdo pain, symptoms of dehydration, weight loss

20

What is constipation? Due to?

Excessively hard stools usually caused by increase absorption of liquid as a result of slow transit through the large bowel

21

What is constipation associated with?

Reduction in the frequency of defecation and a feeling of incomplete evacuation of the bowels

22

What should you clarify is a patient is constipated?

Clarify exactly what they mean by the word constipation

23

What are some causes of constipation?

- low fibre diet
- medications such as codeine
- medical conditions
- bowel cancer
- immobility
- hypothyroidism

24

What is rectal bleeding?

Passage of blood or clots from the rectum

25

What should you ask about with regards to rectal bleeding?

Amount of blood?
Colour?

26

What can rectal bleeding be a sign of?

- Haemorrhoids, anal fissure, colorectal cancer etc.
If there is blood in diarrhoea = can be inflammatory bowel disease

27

How can you tell the origin of the blood in rectal bleeding?

The colour:
Bright Red = close to the anus
Darker/Maroon red= first regions of the large intestine
Black = upper GI tract

28

What is the medical term for black stools?

Malaena

29

What are black stools an indication of?

- upper gastrointestinal bleeding

30

What does upper GI bleeding manifest as?

haeatemesis, melaena or rarely rectal bleeding

31

What should you enquire about if constipation or rectal bleeding are presenting?

- family Hx of bowel cancer

32

Why do the stools appear black?

Because the blood is oxidised by bacteria as it passes through the intestines.

33

What are some useful ways to show that patient you are listening and understanding what they are saying to you?

- repetition of what they are saying exactly?
- Paraphrasing
- Summarising