CONSTIPATION

Check

• Lack of rectal tone seen especially in the elderly.
• Constipation with overflow - hard motion fills rectum and won't move. Soft faeces froin above flows round it; and often leaks from rectum.
• Constipation due to anal irritation.
• Check "real" constipation. Some individuals only pass motions twice a week. They may need reassurance.
• Occasional and/or recent onset of constipation.

Danger signs

• Sexual abuse in children rarely presents as anal soreness causing constipation.
• Change in bowel habit in elderly. If anything more than transient occurs -Contact GP

Notes for children

• Sometimes related to dehydration, especially in over wrapped, overheated infants.
• Anal tissue/worms may cause restricted bowel movement in young children.

Notes for the elderly

• Look for constipation in urinary incontinence.
• Try to avoid stimulants unless absolutely necessary - may need more and more.
• Osmotic laxatives may upset those on diuretics and low salt diets,

General advice

• Adequate fluids.
• Adequate dietary fibre.
• Use bulk forming stimulant, or osmotic laxatives.
• Exercise may help in many cases.

Therapy

• Bulk forming laxatives.
• Stimulant laxatives.
• Osmotic laxatives,

Dictionary

Osmosis: the phenomenon of the passage of certain fluids and solutions through a mebrane or other porous substance

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