Presentation
We present the case of an 11-year-old boy with a 4-month history of chronic constipation and abdominal pain who presented to the children's ED. He was found to have a large abdominal mass that was determined to be a myxoid liposarcoma. [ncbi.nlm.nih.gov]
[…] depends on the underlying cause and the duration that it has been present. [en.wikipedia.org]
Entire Body System
- Pain
PURPOSE: Abdominal pain is not used to characterize constipated patients. [ncbi.nlm.nih.gov]
Figures and Tables - Analysis 3.2 Comparison 3 Relief of Abdominal Pain, Outcome 2 Relief of Abdominal Pain ‐ Children. Figures and Tables - Analysis 3.3 Comparison 3 Relief of Abdominal Pain, Outcome 3 Relief of Abdominal Pain ‐ Adults. [dx.doi.org]
- Fatigue
Constipation, dry mouth, decreased appetite, sweating and fatigue were highly prevalent in the previous 30days (51-80%). [ncbi.nlm.nih.gov]
This is especially true if you’re having other symptoms like fatigue, hair loss, abdominal cramping, weight changes, or vision problems. [healthline.com]
— Beth Mole, Ars Technica, "PETA roasts Impossible Burger for rat tests, suggests patties cause cancer," 11 Aug. 2018 Chemo can cause side effects like nausea and vomiting, hair loss, fatigue, mouth sores, constipation, diarrhea, and more. — Korin Miller [merriam-webster.com]
[…] doctor's examination Toxins Infant botulism A sudden reduction in the ability to suck Loss of muscle tone Sometimes consumption of honey before age 12 months A test for botulinum toxin in stool Lead poisoning Usually no symptoms Possibly abdominal pain, fatigue [merckmanuals.com]
- Crying
If you are a parent, you probably watch your baby’s every laugh, hiccup, and cry for clues about their well-being. Some signs of a problem, though, can be a little more difficult to detect. [healthline.com]
Crying while straining may be a sign of constipation. When a child is constipated, the stool in the intestines has backed up more than it should. What “more than it should” means varies depending on the age of the child and the diet. [drgreene.com]
Can't pass a stool or pain when passing a stool Crying when passing a stool (bowel movement or BM) or Can't pass a stool after straining or pushing longer than 10 minutes or 3 or more days without passing a stool (Exception: Breastfed and over 1 month [seattlechildrens.org]
Signs of constipation Children may sometimes say that it hurts when doing a poo, or cry, and will try to do their poos less often. Often they don't say anything. [cyh.com]
So babies tend to strain, cry, and get red in the face when they have a bowel movement. This does not mean they are constipated. If bowel movements are soft, then there is likely no problem. [medlineplus.gov]
- Feeding Difficulties
[…] with low-fiber formulas Clinical evaluation Drug adverse effects Use of anticholinergics, antidepressants, chemotherapeutics, or opioids Suggestive history Clinical evaluation Toxins Infant botulism New onset of poor suck, feeding difficulties, anorexia [merckmanuals.com]
Gastrointestinal
- Abdominal Pain
PURPOSE: Abdominal pain is not used to characterize constipated patients. [ncbi.nlm.nih.gov]
Figures and Tables - Analysis 3.2 Comparison 3 Relief of Abdominal Pain, Outcome 2 Relief of Abdominal Pain ‐ Children. Figures and Tables - Analysis 3.3 Comparison 3 Relief of Abdominal Pain, Outcome 3 Relief of Abdominal Pain ‐ Adults. [dx.doi.org]
- Nausea
Lubiprostone is generally well tolerated, with nausea being the most common adverse event. AIMS: To characterize nausea with lubiprostone using pooled results from clinical studies in patients with CIC, OIC, or IBS-C. [ncbi.nlm.nih.gov]
fecal impaction, appendicitis, nausea, vomiting, or acute abdominal pain Interactions Decreases effects of warfarin and increases effects of phenolphthalein Pregnancy C - Safety for use during pregnancy has not been established. [web.archive.org]
- Abdominal Cramps
[…] of sudden kidney failure Sorbitol Abdominal cramps and flatulence Stimulant laxatives Anthraquinones (found in senna, cascara, and castor oil) Abdominal cramps and dehydration Stimulant laxatives are not used if there is a possibility of an intestinal [merckmanuals.com]
- Rectal Bleeding
Diagnosis of primary chronic constipation involves a multistep process initiated by the exclusion of 'alarm' features (for example, unintentional weight loss or rectal bleeding) that might indicate organic diseases (such as polyps or tumours) and a therapeutic [ncbi.nlm.nih.gov]
Constipation also requires an immediate assessment if it is accompanied by worrisome symptoms such as rectal bleeding, abdominal pain and cramps, nausea and vomiting, and involuntary weight loss. [web.archive.org]
However, if the pain is severe, or if you have rectal bleeding, call your provider. Learn more: Gas and bloating during pregnancy Heartburn during pregnancy Your pregnancy diet: The basics of eating well [babycenter.com]
These include rectal bleeding and faecal impaction - where dried, hard stools collect in your rectum and anus. [express.co.uk]
Symptoms of constipation may include: Many days without normal bowel movements Hard stools that are difficult or painful to pass Abdominal pain, such as stomachaches, cramping, or nausea Rectal bleeding from tears, called fissures Soiling Poor appetite [healthychildren.org]
- Abdominal Bloating
Lubiprostone-treated patients reported significant improvements in stool consistency, straining, and constipation severity at all weeks, and in abdominal bloating at week 1. [ncbi.nlm.nih.gov]
Urogenital
- Pollakisuria
[…] to opioid use mt Fejn t-tagħrif mogħti bis-saħħa ta en Diarrhoea, constipation, vomiting, nausea, abdominal pain, abdominal distension, dyspepsia mt It-test bl-Estonjan biss huwa awtentiku en Diarrhoea, nausea, abdominal pain, constipation, dry mouth Pollakisuria [glosbe.com]
Neurologic
- Irritability
Clinical study results in patients with Chronic Idiopathic Constipation (CIC) and Irritable Bowel Syndrome with Constipation (IBS-C) are also reviewed. [ncbi.nlm.nih.gov]
Common causes include slow movement of stool within the colon, irritable bowel syndrome, and pelvic floor disorders. [en.wikipedia.org]
Workup
CONCLUSIONS: CME programs focusing on applying diagnostic criteria, matching diagnostic workup to patient presentation, treatment selection, and identifying patients who may benefit from psychological evaluation may fill knowledge and practice gaps of [ncbi.nlm.nih.gov]
Diagnosis An extensive workup of the constipated patient is performed on an outpatient basis and usually occurs after approximately 3-6 months of failed medical management. [emedicine.com]
X-Ray
- Bowel Distention
Osmotics cause fluids to flow in a special way through the colon, resulting in bowel distention. This class of drugs is useful for people with idiopathic constipation. Brand names include Cephulac, Sorbitol, and Miralax. [web.archive.org]
Treatment
[…] within 6 weeks of treatment starting. [pathways.nice.org.uk]
The treatment efficiency was evaluated and compared between two different treatments. [ncbi.nlm.nih.gov]
Prognosis
AIM: To compare the efficacy, improved quality of life, and prognosis in patients undergoing either subtotal colonic bypass with antiperistaltic cecoproctostomy (SCBAC) or subtotal colonic bypass plus colostomy with antiperistaltic cecoproctostomy (SCBCAC [ncbi.nlm.nih.gov]
Prognosis was poor in all these cases. At autopsy, pseudo-membranous mucosal changes were revealed all over the colon, particularly in the rectum and sigmoid colon. [doi.org]
Prognosis: With appropriate dietary management, prognosis in most patients is excellent. Recurrence depends on the patient's long-term compliance to therapy. [web.archive.org]
Prognosis Most active patients do well with medical management and appropriate dietary management. Recurrence depends on the patient’s long-term compliance with therapy. [emedicine.com]
Etiology
The diagnosis can be made using standard criteria, and in the absence of alarm signs or symptoms, a determination of the underlying etiology/etiologies should be undertaken. [ncbi.nlm.nih.gov]
The understanding of the etiology of chronic constipation is the foundation on which cost-effective management strategies are to be built. Keywords Chronic constipation Etiology This is a preview of subscription content, log in to check access. [doi.org]
Constipation with a clear etiology (drugs, trauma, bed rest) may be treated symptomatically without further study. [merckmanuals.com]
Epidemiology
This review will focus on the definition, epidemiology, diagnostic approach, and non-pharmacologic as well as pharmacologic management of chronic constipation in the elderly, including an overview of new medications currently under clinical investigation [ncbi.nlm.nih.gov]
The frequent occurrence of constipation and its impact on public health stress the need for further studies devoted to the epidemiology and basic pathophysiology of this condition. [doi.org]
Pathophysiology
In this Review, we provide an overview of the burden and pathophysiology of chronic constipation, as well as a detailed discussion of the available diagnostic tools and treatment options. [ncbi.nlm.nih.gov]
Prevention
Agents Used to Prevent or Treat Constipation Agent Some Side Effects Comments Bulking agents (fiber)* Bran Bloating, passing of gas (flatulence), and poor absorption of iron and calcium Bulking agents generally are used to prevent or control chronic constipation [msdmanuals.com]
Prevention of constipation Prevention of constipation involves making diet and lifestyle changes. This includes eating high-fibre foods, drinking plenty of fluids and regularly exercising. [news-medical.net]
OBJECTIVE: Auricular acupressure (AA) therapy has been widely used in Eastern Asia and Europe to prevent constipation in leukemia patients undergoing chemotherapy. [ncbi.nlm.nih.gov]