Constipation

 

 Constipation

Definition

It is a condition characterized by passage of hard and dry stools once in 3 days or more.

Aetiology

Type of cause	Conditions
Local	.Piles: The patient avoids passing stools out of fear of bleeding associated with it. .Tumor or malignancy near the anus. .Intestinal obstruction.
General	.Avoiding passing stools when there is a desire to do so. .Any general illness, especially if associated with fever. .Bad habits like inability to pass stools without smoking or application of tobacco paste to the gums. .Inadequate diet or inadequate roughage in diet. .Inadequate water intake. .Inadequate exercise. .Weakness of intestinal smooth muscle due to any cause. .Paralytic ileus. .Drugs, e.g. prolonged rug therapy for diarrhea. .Non availability of adequate facilities ,e.g. Clean toilet.

 

 

Clinical features

1.Constipation.

2.Pain in and around the anus during passage of stools.

3.Headache.

4.Giddiness.

5.Nausea.

6.Loss of appetite.

7.Restlessness.

8.Sleeplessness.

9.Flatulence.

10.Coated tongue.

11.Faecal masses are felt on palpation of the left iliac.

12.Hard faecal masses are felt on per rectal examination.

13.Dyschezia is a condition in which the faecal concretions are so hard that they have to be removed by passing in a gloved finger through the anus.

 

Nursing care

1.The cause of constipation is found out, because if it requires surgical treatment ,it must be given in time and general nursing measures are unlikely to be useful.

2.If the patient is habituated to infrequent passage of stools which is of normal consistency ,and there is no objection from medical point of view, he may not be treated.

3.Adequate food intake is ensured, especially with high roughage in it, as in the following food articles.

           .Green leafy vegetables.

           .Bananas.

4.Adequate water intake is ensured.

5.Adequate exercises are prescribed.

6.Good bowel habit are developed.

7.Aglass of warm water is given at bed time

8.A glass of warm milk with two teaspoons of ghee is given at bedtime.

9.If all these measures fail, medical treatment is given .

 

Medical treatment

1.Laxative:A laxative is a preparation which softens stool without causing purgation

             .Liquid paraffin

              .Emulsion of liquid paraffin (cremaffin).

              .Isapgot.

2.Mild purgative: It causes mild purgation.

             .Bisacodyl( Dulcolax).

             .Phenolphthalein(often mixed with emulsion of liquid paraffin, e.g.cremaffin pink).

             .Cascara.

             .Sagrada.

             .Senna.

3.Rectal suppositories:These are oily,elongated tablets which are inserted into the rectum through the anus. They liquefy at body temperature and release the medication inside them for local action. The following types of rectal suppositories are available.

              .Bisacodyl.

              .Glycerin.

4.If the preceding measures fail,an oil or glycerin enema is given.