General

Constipation ??? How to manage it !!!

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14 Jul 2016 - General
 

Chronic constipation can be defined as infrequent bowel motion, painful passage of stool, hard consistency of stool or difficulty in evacuating stool. It affects female more than male. Chronic constipation is a common condition in the population, with increase in prevalence with increase age. ROME III criteria is used to defined and diagnosis chronic constipation. Managment of chronic constipation can be challenging among the primary care physicians and as well as the gastroenterologists !!! There are a variety of investigations and treatment options,including dietary intervention for patient with chronic constipation.But sometime those strategies can be ineffective.  What are your experience and challenges in dealing with chronic constipation ??? 

Hi You Yi. Appreciate your interest. Well, sorry if I was not clear. What I meant was we do radiological investigations for non specific abdominal pain if that lasts for longer than 6 months to exclude any other pathology for the abdominal pain. Constipation is a common cause for non specific abdominal pain, so in the event that all the basic investigations are normal and a cause for the abdominal pain cannot be found, we treat the child as for constipation and see if the child improves. After a...
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Chronic constipation in geriatrics . I will always request patient to increase exercise, ensure adequate hydration, avoid codeine containing cough mixture, take lactulose on a regular basis. If they remain no bowel output for more than 48 hours, I will advise them to take 2 ducolax at night. If the remain NBO they next day, to fleet themselves. If still NBO, to return to me for keep in view bowel evacuation. In paediatrics, I will advise prune juice every morning. I will review their toileting ...
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Hi You Yi, when I was a general surgery resident, I recall that treatment for functional constipation depends on the severity. Initially a trial of stool softeners/ laxatives are given. Adult patients are also prescribed with dietary fiber supplementation. Patients are generally advised to drink adequate amount of water and high fiber diet. If these fail and patients go to the emergency room, patients are given an enema, if they do not have contraindications. Sometimes general surgery residents ...
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Hi Theekshana, thanks for the great information with regards constipation in the paediatric population. As I am working in adult medicine, I am not so familiar with issue of paediatric constipation. It seem like most of the management plans are similar with adult medicine, apart from the toilet training / toilet habit. Just wondering, what specific role of ultrasound scan that you might consider if the child constipation persist for more than 6 months ?? I supposed U/S abdomen ? but how it will ...
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Working in paediatric surgery, constipation is one of the most common etiologies in children who present with non specific abdominal pain. In children it can be a bit difficult to diagnose constipation because their history is not reliable. Sometimes kids say that they go to the toilet daily, but what really happens is they just sit on the toilet seat without having any bowel opening. We as a routine do a full blood count, CRP and a urine full report in every child who comes with non specific ab...
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