Term
| What are the causes of constipation? |
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Definition
| Poor diet, IBS, laxative abuse, excessive travel, pregnancy, hormonal: diabetes, hypothyroidism; haemorroids, fissures, Disease states: PD, MS; Medications: ANTI: -emetics, -cholinergis, -depressants, -acids, -psychotics, -epileptics; BBs CCBs |
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Term
| What is the non-pharmacological management of consitpation |
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Definition
1. Increase fluid intake
2. Reduce caffeine intake
3. Increase fibre- soluble, insoluble
4. Increase exercise |
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Term
| How does insoluble fibre improve constipation? |
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Definition
Increase stool bulk
Decrease intestinal transit time |
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Term
| How does soluble fibre improve constipation? |
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Definition
| Soften stool by increasing water content |
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Term
| What are four categories of constipation medications (laxatives)? |
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Definition
Bulk forming/bulking agents: psyllium
Osmotic agents: macrogol, lactulose
Stimulants (motility): senna, bisacodyl
Stool softener: docusate |
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Term
| What category of laxatives are recommended for long term use? |
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Definition
| Osmotic: macrogol, lactulose, MgSO4 |
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Term
| What are Mg Salts C/I in? |
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Definition
| Pregnancy, renal problems |
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Term
| What category of laxative is used as an adjunct treatment? |
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Definition
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Term
| How is faecal impaction in children treated at home? |
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Definition
| Macrogol3350 with electrolytes |
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Term
| What are four pathophysiological causes of diarrhoea? |
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Definition
Osmotic: retention of fluid by non-absorbable ions in bowel lumen
Secretory: bacterial enterotoxins cause increased intestinal fluid secretion
Altered intestinal motility: increased
Inflammation: releases mucus, blood and serum into bowel lumen
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Term
| What drugs may cause diarrhoea? |
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Definition
| Antibiotics, acarbose, laxatives, BBs, antineoplastics, PPIs, metformin |
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Term
| How is Acute Gastroenteritis in children treated? |
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Definition
Fluid and electrolyte replenishment
**antibiotics, antidiarrhoeals, antiemetics C/I |
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Term
| What is the treatment for amoebic dysentry? |
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Definition
tinidazole 2g PO d, 3days; OR
metronidazole 7-10days |
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Term
| What are three antimotility drugs? |
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Definition
Loperamide 4mg, 2mg after each unformed stool
Diphenoxylate + atropine
Codeine 30-60mg qid max |
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Term
| What antibiotics are used as prophylaxis (indicated for underlying disease maybe) for traveller's diarrhoea? |
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Definition
Norfloxacin 400mg PO d (3wks)
Ciprofloxacin 500mg PO d (3wks) |
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Term
| In case of moderate to severe travellers diarrhoea, what treatment is used? |
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Definition
azithromycin 1g d (3days); OR
norfloxacin 800mg d (3days); OR
ciprofloxacin 500mg/12hrs (3days)
loperamide may be used with Ab.s |
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Term
| What is used for antibiotic diarrhoea prophylaxis? |
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Definition
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Term
| What is the Rome criteria for IBS? |
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Definition
At least 2 of:
Pain relieved by defacation
Onset of pain with change of bowel frequency
Onset of pain with change in form of stools
(for at least 12wks in 1yr)
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Term
| What are the symptoms of IBS? |
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Definition
| urgency, straining, abdominal bloating, passage of mucus with stool |
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Term
| What disorders can IBS be associated with? |
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Definition
| non-ulcer dyspepsia, oesphageal dysmotility, depression, anxiety |
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Term
| What does management of IBS consist of? |
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Definition
Proper diet management
Diarrhoea: loperamide OR cholestyramine
Constipation: increase fluid and fibre intake, antispasmodics (pain): hyoscine, mebeverine, peppermint oil |
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