Term
| Chronic constipation is defined as at least 2 of the following for at least 12wks in 12mths: |
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Definition
| 1)<3 BMs/wk 2)Excessive straining for 25% BMs 3)Incomplete evacuation /p 25% of BMs 4)Passage of hard or pellet-like stool in 25% BMs |
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Term
| What gender is constipation more common? What age group? |
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Definition
| Females. Children and elderly. |
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Term
| What is the most common cause of constipation? |
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Definition
| Poor dietary (low fiber/fluid intake) and behavioral habits |
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Term
| What genetic pathology might you consider in a pediatric pt w/ chronic constipation? |
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Definition
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Term
| Why are the elderly at increased risk for constipation? (4) |
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Definition
| Polypharmacy, inc. rectal capacity, dec. colonic motility, physical limitations |
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Term
| What meds can cause constipation? |
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Definition
| Chronic laxative/cathartic use, benadryl (anti-cholinergics/anti-histamines), opioids, iron |
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Term
| What dz causing neurologic gut dysfunction can cause constipation? (4) |
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Definition
| Parkinson's dz, MS, sacral nerve damage, and paraplegia |
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Term
| What myopathies cause constipation? |
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Definition
| Dermatomyositis and myotonic dystrophy |
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Term
| What endocrine d/o result in constipation? |
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Definition
| hypothyroidism, hyperparathyroidism, and DM |
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Term
| What electrolyte d/o cause constipation? |
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Definition
| hypercalcemia and hypokalemia |
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Term
| What is normal transit constipation? |
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Definition
| Chronic constipation 2/2 low fiber diet |
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Term
| What are the 2 types of primary constipation? |
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Definition
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Term
| What are causes of slow transit contipation? |
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Definition
| Idiopathic, GI dysmotility syndrome, evacuation d/o (psychosocial - withholding BMs) |
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Term
| What causes secondary constipation? |
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Definition
| Systemic d/o (myopathy, endocrine, lyte d/o), meds, or ileus/obs. |
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Term
| Straining at stools and feeling incomplete evacuation are cardinal sx of what d/o? |
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Definition
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Term
| Absence of anal relaxation and inadequate perineal descent suggests what? |
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Definition
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Term
| Name 6 alarm sx in a pt w/ c/o constipation that would necessitate further w/u. |
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Definition
| Severe constipation, wt loss, rectal bleed, anemia, new in >50yo, family h/o colon CA or IBS |
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Term
| What can result from repeated laxative abuse? |
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Definition
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Term
| What is the tx for pts w/ normal transit constipation? |
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Definition
| Lifestyle changes: bowel training, exercise, high fiber diet, at least 1,500ml fluid/d, stools softeners |
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Term
| Which meds are effective for slow transit constipation? |
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Definition
| 1)Fiber laxative: psyllium 2)Osmotic: polyethylene glycol or lactulose 3)Stimulant: senna |
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Term
| What pt would you not want to use osmotic laxatives? |
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Definition
| CHF or renal insufficiency (pulls water from bowel wall into the lumen) |
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Term
| What tx are used for pediatric constipation? |
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Definition
| {olyethylene glycol (Miralax), apple juice, Karo syrup |
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