Constipation

Constipation

Common GI condition. Due to absence of peristaltic activity in colon – considered constipated is <3 bowel movements a week. Increased incidence in older persons.Aetiology: • Most cases are due to inadequate intake of dietary fibre or dehydration. • Increased risk in those with lack or exercise or poor mobility, especially if bedridden. • Chronic disease – GI disease (irritable bowel syndrome, hernia’s, diverticulosis, neoplasms); neurological diseases (multiple sclerosis, Parkinson’s disease); psychiatric conditions (stress, depression); metabolic (hypokalaemia, diabetes mellitus, hypothyroidism) • Drugs – analgesics (eg codeine, morphine); antihistamines; tricyclic antidepressants; MAOI’s; antihypertensives; NSAID’s; antacids; anticholinergicsClinical features: Subjective complaint – varies from person to person; nausea; ‘bloated’; cramping; difficulty passing stools;Treatment: Increase in daily intake of fibre; decrease in fats, especially cheese; increased fluid intake; regular exercise Laxatives (eg methylcellulose); stool softeners (eg dioctyl sodium sulfosuccinate)

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