Anda di halaman 1dari 17

CONSTIPATION AND

DIARRHEA
Constipation
Defined medically as fewer than three stools per week and severe
constipation as less than per week.
Usually caused by the slow movement of material through the colon
The 2 disorders limited to the colon that cause constipation are
colonic inertia and pelvic floor dysfunction
Symptoms
Infrequent bowel movements
Lower abdominal discomfort
Straining to have a bowel movement
Hard or small stools
Rectal Bleeding
Physiological distress and/or obsession with having bowel movement
Causes
Medications NARCOTIC MEDS (codeine)
antidepressants (amitriptyline)
anticonvulsants (phenytoin)
iron supplements
Calcium channel blockers drugs (diltiazem, nifedipine)
Poor bowel habits
Low fiber diets - (maintaining soft, bulky stool)
Possibly abuse of laxatives (senna, castor oil, many herbs)
Hormonal disorders too little thyroid hormone, and too much
parathyroid hormone
Test to diagnose
History taking
Physical Examination
Blood Tests
Abdominal X-rays
Colonic Transit Studies
Defecography
Anorectal Motility Studies
Colonic Motility Studies
Treatment
Increase fluid intake
High in Fiber
Non-Stimulant Laxatives/ Stimulant Laxatives
Enemas
Suppositories
Biofeedback Training
Exercise
Prescription Medication (lubiprostone, linaclotide, colchicine)
Surgery
Dietary Fiber
1. Fruits and vegetables
2. Wheat or oat bran
3. Whole grains
Bulk-forming and lubricant laxatives
Stool Softeners
Diarrhea
Increase in the frequency of bowel movements or decrease in the
form of stool.
Other Causes:
Incontinence of stool
Rectal Urgency
Incomplete Evacuation
Bowel movement immediately after eating a meal
Reasons for diarrhea
1. Secretory Diarrhea
2. Osmotic Diarrhea
3. Motility-Related Diarrhea
4. Collagenous Colitis
5. Inflammatory Diarrhea
Divided into 2 parts
Acute Diarrhea
lasts from a few days up to a week
Chronic Diarrhea
lasts more than 3 weeks
Common Causes of Acute Diarrhea
Viral bacteria
1. E. Coli
2. Viral Gastroenteritis
3. Bacterial Enterocolitis
4. Food Poisoning
Parasitic
1. Cryptosporidium
Drugs
Common Causes of Chronic Diarrhea

Irritable Bowel Syndrome


Infectious Diseases
Bacterial Overgrowth of the small intestine
Post-Infectious
Inflammatory Bowel Disease
Colon Cancer
Severe Constipation
Carbohydrate/Fat Malabsorption
When should the Doctor be called for
diarrhea?
High Fever 38.3 degree celcius
Moderate/Severe abdominal pain or thenderness
Bloody diarrhea
Severe diarrhea that shows no improvement after 48 hours
Moderate or severe dehydration
Prolonged vomiting
How is the cause of diarrhea diagnosed?
(acute diarrhea)
Stool Exam
Measurement of bp in the sitting and then the upright positions can
demonstrate orthostatic hypotension (a marked drop in the blood
pressure) and confirm the presence of dehydration. If moderate or
severe dehydration or electrolyte deficiencies are likely, blood
electrolytes can be measured.
Immunologic tests can be done also on samples of stool to diagnose
infection causes of diarrhea.
How is the cause of diarrhea diagnosed?
(chronic diarrhea)
X-ray of the intestines
Fat mal-absorption measuring the fat in a 72 hour collection of stool
Sugar Mal-absorption performing hydrogen breath test
Celiac disease diagnosed with blood tests and a biopsy of the small
inrestines
Home Remedies
3 that have been studied and appear to be effective are:
1. pectin
2. cooked green bananas, and
3. probiotics
Medications
1. Absorbents attapulgite, polycarbophil, psyllium
2. Anti-motility Meds loperamide, diphenoxylate
3. Bismuth Compounds Bismuth subsalicylate

Anda mungkin juga menyukai