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Chronic Constipation


Presentation

  • Case Presentation A previously healthy 14-year-old girl presents to the emergency department with 3 days of worsening left-sided abdominal pain. She reports multiple episodes of nonbloody, nonbilious emesis and constipation.[pedsinreview.aappublications.org]
  • A brief summary of lubiprostone and linaclotide is also presented. The quality of evidence is presented by adopting the Grading of Recommendations, Assessment, Development and Evaluation system.[ncbi.nlm.nih.gov]
  • This study presented interesting findings that support the association between constipation and methanogenic bacteria.[frontiersin.org]
  • […] in the stool, there is a history of inflammatory bowel disease or colon cancer in a person's family, or it is of new onset in someone who is older. [11] Treatment of constipation depends on the underlying cause and the duration that it has been present[en.wikipedia.org]
Early Satiety
  • Borody et al. ( 42 ) performed FMT on 4 patients with chronic constipation and demonstrated immediate improvements in symptoms, such as abdominal pain, early satiety, and nausea, as well as a significant improvement in defecation frequency to once or[frontiersin.org]
Black Stools
  • Call your doctor or go to the nearest hospital emergency room right away if you develop unusual or severe stomach-area (abdominal) pain, especially if you also have bright red, bloody stools or black stools that look like tar.[linzess.com]
Recurrent Abdominal Pain
  • Recurrent abdominal pain or discomfort is the hallmark difference that distinguishes patients with functional chronic constipation from constipation-dominant IBS (IBS-C).[ncbi.nlm.nih.gov]
Suggestibility
  • They suggested that the result was due to the high placebo effect which synbiotics failed to demonstrate benefit over the controls.[frontiersin.org]
  • Although these studies did not consistently show that physical activity improved constipation, they suggest that physical activity improves QoL. A similar association has also been reported in patients with IBS-C.[ncbi.nlm.nih.gov]
Fear
  • Target investigations that directly address patient fears and additional tests that were omitted from previous assessments are generally adequate to ameliorate patient concerns.[ncbi.nlm.nih.gov]
  • Psychological Voluntary withholding of the stool is a common cause of constipation. [15] The choice to withhold can be due to factors such as fear of pain, fear of public restrooms, or laziness. [15] When a child holds in the stool a combination of encouragement[en.wikipedia.org]
Forgetful
  • Toddlers are like elephants, they never forget! Step 3: How can we eliminate the pain associated with bowel movements? The key to eliminating pain associated with bowel movements is to be sure the bowel movements are soft and not particularly large.[med.virginia.edu]

Workup

Torsades De Pointes
  • Prucalopride The cardiovascular toxicity of cisapride and tegaserod is related to their nonspecific effect on the delay rectifying potassium (HERG-K) channel that leads to prolong QT interval, precipitating torsade de pointes.[ncbi.nlm.nih.gov]

Treatment

  • More than 70% of respondents noted that having to take just one pill a day made Resotran an easy treatment to follow.[badgut.org]
  • […] as the initial conservative treatment for chronic constipation.[ncbi.nlm.nih.gov]
  • How long does treatment need to continue? Length of treatment varies from child to child. In general, we must treat younger children for longer periods of time than older children.[med.virginia.edu]
  • Diarrhea often begins within the first 2 weeks of LINZESS treatment. Stop taking LINZESS and call your doctor right away if you get severe diarrhea during treatment with LINZESS.[linzess.com]
  • […] from 2.0 0.3 at pretreatment to 3.3 0.2 at 12 weeks post-treatment ( p 0.0025).[frontiersin.org]

Prognosis

  • Furthermore, it has a very variable rate of success and is very case dependent. [29] Prognosis Complications that can arise from constipation include hemorrhoids, anal fissures, rectal prolapse, and fecal impaction. [15] [22] [46] [47] Straining to pass[en.wikipedia.org]

Etiology

  • Constipation: etiology, evaluation and management. New York: Springer. a b c Tabbers, M.M.; DiLorenzo, C.; Berger, M.Y.; Faure, C.; Langendam, M.W.; Nurko, S.; Staiano, A.; Vandenplas, Y.; Benninga, M.A. (2014).[en.wikipedia.org]

Epidemiology

  • Epidemiology Constipation is the most common chronic gastrointestinal disorder in adults.[en.wikipedia.org]
  • Epidemiology of constipation in North America: A systematic review. Am J Gastroenterol. 2004; 99 :750–9. [ PubMed ] [ Google Scholar ] 2. Wald A, Scarpignato C, Mueller-Lissner S, et al.[ncbi.nlm.nih.gov]
Sex distribution
Age distribution

Pathophysiology

  • "Constipation of anorectal outlet obstruction: Pathophysiology, evaluation and management". Journal of Gastroenterology and Hepatology. 21 (4): 638–646. doi : 10.1111/j.1440-1746.2006.04333.x.[en.wikipedia.org]

Prevention

  • Constipation is usually easier to prevent than to treat.[en.wikipedia.org]
  • Constipation prevention: Empiric use of stool softeners questioned. Geriatrics. 1991; 46 :84–6. [ PubMed ] [ Google Scholar ] 29. McRorie JW, Daggy BP, Morel JG, Diersing PS, Miner PB, Robinson M.[ncbi.nlm.nih.gov]

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