Term
| Definition of Constipation |
|
Definition
Less than 3 BMs/ week
OR
Two or more of the following:
- lumpy/hard stools >25% of the time
- straining >25% of the time
- incomplete evacuation >25% of the time
- sensation of blockage >25% of the time
- manual maneuvers to facilitate >25% of the time |
|
|
Term
| Drugs with constipating Effects |
|
Definition
Antacids containing aluminum or calcium
Anticholinergics
Anticonvulsants
Antiparkinsonians
antipsychotics
Bismuth preparations
CCBs
Diuretics that cause hypokalemia
Iron supplements
Opioids
Resins
Sucralfate |
|
|
Term
| Immediate treatments of constipation? |
|
Definition
| Manual disimpactation, or an enema |
|
|
Term
| Recommended daily dietary fibre |
|
Definition
|
|
Term
| What are the short term (3-4 day), rapid response treatments for constipation |
|
Definition
Magnesium sulfate/citrate/hydroxide
OR
Bisacodyl, Cascara, Senna
Or
Lactulose
Or Sodium Phosphates |
|
|
Term
What are the bulk forming agents?
What must they be taken with? |
|
Definition
Polycarbophil Calcium, Psyhillium, Sterulia Gum
Must be taken with adequate fluid |
|
|
Term
| Good solution for constipation with heartburn? |
|
Definition
| Magnesium containing antacid |
|
|
Term
What can result from stimulant laxative use?
What agents should be used to combat this? |
|
Definition
| Refractory Constipation - use lactulose or PEG |
|
|
Term
| What agents should be avoided in pregnancy? |
|
Definition
Castor oil - associated with intrauterine contractions
Mineral oil - interfere with absorption of lipid soluble vitamins |
|
|
Term
| Non-pharm options for constipation? |
|
Definition
Dietary & supplementary fibre (20-30g/day)
Increased fluid intake
Physical exercise |
|
|
Term
| When should a patient be referred? |
|
Definition
| Refer patient for: Worsening constipation, rectal bleedeing |
|
|
