Adult Constipation: The 3 causes to consider when presenting with less than 3 BMs a week скачать в хорошем качестве

Adult Constipation: The 3 causes to consider when presenting with less than 3 BMs a week

Constipation is a common presenting complaint with a number of causes. While constipation may be due to functional or organic causes, it may also be the sign of serious underlying pathology. Therefore, a careful assessment must be performed, including identification of red flags, to rule out causes such as bowel cancer. medskl.com is a global, free open access medical education (FOAMEd) project covering the fundamentals of clinical medicine with animations, lectures and concise summaries. medskl.com is working with over 170 award-winning medical school professors to provide content in 200+ clinical presentations for use in the classroom and for physician CME. Gastroenterology – Adult Constipation Whiteboard Animation Transcript with Christopher Ma, MD and Edwin Cheng, MD https://medskl.com/module/index/adult... Constipation in adults is common, typically defined by less than 3 bowel motions per week, and can be caused by both benign and serious conditions. We organize our approach to chronic constipation by differentiating patients with primary or functional constipation and those with secondary causes. Here are three causes of constipation in adults you need to know about. Primary constipation can be from normal or slowed colonic transit or primary defecation disorders. Patients with normal transit constipation pass hard stools but have normal colonic motility. This is often seen in the setting of poor fibre and fluid intake or stress. In contrast, patients with slow transit constipation have prolonged colonic transit time from reduced colonic intrinsic nerve activity. They often do not feel the urge to defecate despite very infrequent bowel motions. Finally, primary constipation can result from defecatory disorders such as anorectal dyssynergia. This is caused by incoordination of the pelvic floor muscles, often from poor toileting habits. These patients complain of significant straining and may respond to biofeedback. Secondary constipation can be related to structural obstructions to stool transit. The most worrisome structural cause is colorectal cancer, which develops in up to 1 in 14 men and 1 in 16 women! Patients with a family history of colon cancer or inflammatory bowel disease are at particularly high risk. Patients over 50 with iron deficiency anemia or acute change in bowel habits need endoscopic evaluation to rule out colon cancer.