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Management of Constipation in Family Medicine PowerPoint Presentation

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Description : Check out this medical presentation on Constipation and Defecation Problems, which is titled "Management of Constipation in Family Medicine", to know about constipation, condition in which a person has fewer than three bowel movements a week or has bowel movements with stools that are hard, dry, and small, making them painful or difficult to pass.

Tags : Constipation, Defecation Problems, Management

Published on : Jul 10, 2021 | Views : 2270 | Downloads : 3

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Slide 1-

Management of Constipation in Family Medicine Meera Kaur, PhD, RD, CDE Assistant Professor, Family Medicine University of Manitoba, Canada http://home.cc.umanitoba.ca/~kaur/
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15 76 year old female with PMHx of HTN & DM-2, presents to the clinic. She’s complaining of having stools only twice a week, and feeling “full.” She’s eating more vegetables, started drinking more water, and she recently included Metamucil to her diet. Her last colonoscopy one year ago was clean. She comes to your office to be evaluated for her constipation. What would you offer her for the constipation? - A. Lactulose - B. Senna - C. Docusate - D. Weekly tap water enemas Case
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Is a symptom, not a disease Is a condition in which a person has fewer than three bowel movements a week or has bowel movements with stools that are hard, dry, and small, making them painful or difficult to pass Has varied meanings for different individuals, patients and care givers It is best when the stools are soft and passed at an hour customary to the patients when in health Hippocrates 2 What is constipation?
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Patients’ Definition Straining 52%, hard stools 44%, infrequent stool 32% Misconception 62% believe that daily defecation is necessary to good digestive health Ala, 2006 3 Patients definition & concept about constipation
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4 Rome III criteria: 2 of the below defines constipation Straining Lumpy Hard Stools Incomplete Evacuation Use of Digital Rectal Maneuvers Sensation of Anorectal Blockage < 3 Bowel Movements per week Rome III Criteria
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Good history is enough for most cases Duration, frequency, Consistency, blood in the stool, weight loss, Diet, Exercise, Toilet habits, Laxative use (what), other drugs Basic laboratory test CBC, Electrolytes, BS, BUN, Cr, TSH Structural Barium enema Sigmoidoscopy Colonoscopy 5 Diagnosis
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Primary cause Primary Colorectal dysfunction Slow Transit Dyssnerygic Defecation Irritable Bowel Syndrome Secondary cause Endocrine/Metabolic Neurologic Myogenic Disorders Medications Obstruction Chronic Idiopathic Constipation (CIC) 6 Causes
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Initial Management of chronic functional constipation Lifestyle changes Exercise Establishing regular bowel regimen pattern Early rising from bed Diet High fibre (20-35 g/day including both soluble and insoluble components) ↑ Fluid intake ↓ soft drinks, caffeinated drink 7 Management…
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Bulk forming agent Metamucil Citrucel Konsyl Serutan Osmotic agent Milk of Magnesia Fleet Phospho-Soda Sorbitol Cephulac Miralax 8 Management…Medication…
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Stool Softener Colace Docusate Surfak Lubricants Fleet Zymenol 9 Management…Medication…
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Stimulant Correctol Dulcolax Purge Senokot Chloride Channel Blockers Lubiprostone (Amitiza) 10 Management…Medication…
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Surgery Biofeedback Alternative and Complementary Medicine Yoga Warm water + Honey Herbal preparation Homeopathic and Ayurvedic treatment 11 Management
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Hemorrhoid Anal Fissures Rectal Prolapse Fecal Impaction 12 Complication
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13
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14 References Books Journal articles published during 1990-2012 International, National and Provincial governments’ relevant websites Regulatory organizations’ websites and reports Other relevant organizations’ publications/reports Guidelines, and References are available on request
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Thank you 15
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15 Constipation in the older adult may be due to chronic constipation, secondary etiologic factors A thorough history must be obtained to rule out secondary causes. Therapy includes: Diet/lifestyle Stimulant Laxatives Osmotic Laxatives Bulk Forming agents Other therapy Summary
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Questions? 16