15 CONSTIPATION General Discussion A complaint of constipation may mean very different things to different patients. A complaint of constipation may mean infrequent bowel movements, straining while stooling, incomplete evacuation, abdominal pain, abdominal bloating, hard stools, small stools, or a need for digital manipulation to enable defecation. An international committee has recommended definitions of chronic functional constipation. The Rome II criteria for functional constipation are two or more of the following symptoms for at least 12 weeks in the past 12 months: • Straining in more than 1 out of 4 defecations • Lumpy or hard stool in more than 1 out of 4 defecations • Sensation of incomplete evacuation in more than 1 out of 4 defecations • Sensation of anorectal obstruction or blockage in more than 1 out of 4 defecations • Manual maneuvers to facilitate more than 1 out of 4 defecations • Fewer than three bowel movements per week • Loose stools are not present and there is insufficient criteria for irritable bowel syndrome There are a wide variety of potential causes of constipation, and the majority of individuals with constipation do not have an identifiable cause to explain their symptoms. Constipation may occur due to an alteration in stool consistency, stool caliber, or colonic motility. Constipation also may result from a change in the process of rectal evacuation, usually due to an obstruction of the movement of luminal contents or poor colonic propulsive activity. It is important to distinguish functional constipation from other disorders that may be associated with altered bowel habits. The evaluation of constipation aims to exclude systemic disease or a structural disorder of the intestines. Medications Associated with Constipation Adrenergic agents Aluminum antacids Anticholinergics Anticonvulsants Antihistamines Antiparkinson drugs Antipsychotics Antispasmodics Barium sulfate Beta blockers Calcium Calcium channel blockers Diuretics Iron supplements NSAIDs Opioids Sucralfate Tricyclic antidepressants Causes of Constipation Adhesions Amyloidosis Anorexia nervosa Autonomic neuropathy Bulimia nervosa Cerebrovascular disease Colorectal cancer Congenital megacolon (Hirschsprung’s disease) Depression Dermatomyositis Diabetes mellitus External compression Only gold members can continue reading. Log In or Register to continue Share this:Click to share on Twitter (Opens in new window)Click to share on Facebook (Opens in new window) Related Related posts: ARTHRITIS AND ARTHRALGIA GYNECOMASTIA INFERTILITY, MALE SYNCOPE Stay updated, free articles. Join our Telegram channel Join Tags: Instant Work-ups A Clinical Guide to Medicine Aug 17, 2016 | Posted by admin in PEDIATRICS | Comments Off on CONSTIPATION Full access? Get Clinical Tree
15 CONSTIPATION General Discussion A complaint of constipation may mean very different things to different patients. A complaint of constipation may mean infrequent bowel movements, straining while stooling, incomplete evacuation, abdominal pain, abdominal bloating, hard stools, small stools, or a need for digital manipulation to enable defecation. An international committee has recommended definitions of chronic functional constipation. The Rome II criteria for functional constipation are two or more of the following symptoms for at least 12 weeks in the past 12 months: • Straining in more than 1 out of 4 defecations • Lumpy or hard stool in more than 1 out of 4 defecations • Sensation of incomplete evacuation in more than 1 out of 4 defecations • Sensation of anorectal obstruction or blockage in more than 1 out of 4 defecations • Manual maneuvers to facilitate more than 1 out of 4 defecations • Fewer than three bowel movements per week • Loose stools are not present and there is insufficient criteria for irritable bowel syndrome There are a wide variety of potential causes of constipation, and the majority of individuals with constipation do not have an identifiable cause to explain their symptoms. Constipation may occur due to an alteration in stool consistency, stool caliber, or colonic motility. Constipation also may result from a change in the process of rectal evacuation, usually due to an obstruction of the movement of luminal contents or poor colonic propulsive activity. It is important to distinguish functional constipation from other disorders that may be associated with altered bowel habits. The evaluation of constipation aims to exclude systemic disease or a structural disorder of the intestines. Medications Associated with Constipation Adrenergic agents Aluminum antacids Anticholinergics Anticonvulsants Antihistamines Antiparkinson drugs Antipsychotics Antispasmodics Barium sulfate Beta blockers Calcium Calcium channel blockers Diuretics Iron supplements NSAIDs Opioids Sucralfate Tricyclic antidepressants Causes of Constipation Adhesions Amyloidosis Anorexia nervosa Autonomic neuropathy Bulimia nervosa Cerebrovascular disease Colorectal cancer Congenital megacolon (Hirschsprung’s disease) Depression Dermatomyositis Diabetes mellitus External compression Only gold members can continue reading. Log In or Register to continue Share this:Click to share on Twitter (Opens in new window)Click to share on Facebook (Opens in new window) Related Related posts: ARTHRITIS AND ARTHRALGIA GYNECOMASTIA INFERTILITY, MALE SYNCOPE Stay updated, free articles. Join our Telegram channel Join Tags: Instant Work-ups A Clinical Guide to Medicine Aug 17, 2016 | Posted by admin in PEDIATRICS | Comments Off on CONSTIPATION Full access? Get Clinical Tree
