L16: Constipation & Diarrhea

Question 1

Def of Constipation

Answer 1

Question 2

Incidence of Constipation

Answer 2

affects more than one in five of
The population

Question 3

Causes of Constipation

Answer 3

• Poor dietary and behavioral habits (the most common)
• Structural abnormalities
• Systemic diseases
• Drugs

Question 4

Causes of Constipation
- Poor dietary and behavioral habits (the most common)

Answer 4

1. Low-fiber diet
2. Decreased intake of fluids
3. Ignoring desire of defecation
4. Lack of exercise

Question 5

Causes of Constipation

• Structural Abnormalities

Answer 5

Question 6

Causes of Constipation

• Endocrinal Causes

Answer 6

hypothyroidism, diabetes mellitus & hyperparathyroidism

Question 7

Causes of Constipation

• Metabolic Causes

Answer 7

hypokalemia, hypercalcemia & uremia

Question 8

Causes of Constipation

• Neurological Causes

Answer 8

paraplegia, parkinsonism & multiple sclerosis

Question 9

Causes of Constipation

• Other causes

Answer 9

amyloidosis, scleroderma

Question 10

Causes of Constipation

• Drugs

Answer 10

Question 11

Def of Refractory constipation

Answer 11

It includes patients without identifiable causes and who do not respond to conservative dietary management.

Question 12

these patients can be divided into 2 categories:

Answer 12

1. Colonic inertia (slow colonic transit)
2. Outlet disorders

Question 13

Characters of Colonic inertia

Answer 13

There is prolonged colonic transit time more than 72 hours (normal is 35 h)

Question 14

Another Name of Colonic inertia

Answer 14

Chronic intestinal pseudo-obstruction

Question 15

Causes of Colonic inertia

Answer 15

1. Idiopathic: isolated to the colon or part of generalized disorder
2. Psychogenic

Question 16

Examples of Outlet disorders Causing refractory constipation

Answer 16

 Rectocele & rectal prolapse
 Rectal intussusception
 Anismus

Question 17

These patients may complain of …..

Answer 17

excessive straining with sense of incomplete evacuation the need for digital pressure on the Vagina or perineum

Question 18

Evaluation of a case of Constipation

Answer 18

Question 19

Investigations in Constipation

Answer 19

Question 20

Measurement of the colonic transit time in constipation

Answer 20

• 24 radi0-opaque plastic markers are swallowed on 3 consecutive days.
• An abdominal radiograph is taken on days 4 and 7, and the total number of markers remaining in the colon is counted.

Question 21

Defecography in Constipation

Answer 21

video study taken during straining and defecation.

Question 22

Alarm symptoms of Constipation

Answer 22

Question 23

TTT of Constipation

Answer 23

Question 24

Types of Laxatives used in Constipation

Answer 24

• Osmotic laxatives: (Stool softeners)
• Cathartic (Stimulant) laxatives

Question 25

Examples of **Osmotic Laxatives**

Answer 25

as lactulose, sorbitol & docusate sodium.

Question 26

SE of **Osmotic Laxatives**

Answer 26

They are safe and do not cause dependency.

Question 27

Examples of **Cathartic (Stimulant) laxatives**

Answer 27

bisacodyl, castor oil & Senna

Question 28

Uses of Cathartic (Stimulant) laxatives

Answer 28

They are used in acute constipation and may cause severe cramps & diarrhea

Question 29

SE of **Cathartic (Stimulant) laxatives**

Answer 29

Chronic use of these agents should be avoided and may result in loss of normal colonic neuromuscular function.

Question 30

Enemas in **Constipation**

Answer 30

by saline (non-irritating), tap water (irritating), or oil retention (Useful for hard or impacted stool) enemas.

Question 31

TTT of Colonic Inertia

Answer 31

Chronic use of enemas and cathartic agents.

Question 32

Psychiatric therapy in constipation

Answer 32

for patients with psychological disorders

Question 33

Surgical TTT of Constipation

Answer 33

for outlet obstruction & cancer

Question 34

Def of **Dysentery**

Answer 34

It means diarrhea associated with blood, mucous and tenesmus.

Question 35

Def of **Tenesmus**

Answer 35

Tenesmus means painful defecation with sense of incomplete evacuation

Question 36

Etiology of ****desentery****

Answer 36

Question 37

CP of **desentery**

Answer 37

Question 38

Evaluation of **desentery**

Answer 38

Question 39

Sigmoidoscopy in ameobic dysentry

Answer 39

Flask shaped ulcers with intervening healthy mucosa

Question 40

Sigmoidoscopy in bacillary desentery

Answer 40

Diffuse inflammation with dirty yellowish pseudo membrane

Question 41

Sigmoidoscopy in Bilharzial dysentery

Answer 41

Polyps and ulcers

Question 42

TTT of dysentery

Answer 42