Health Needs::Serach Disease

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Disease	CONSTIPATION

Quotation	“ Please remain seated throughout the performance, even if the program stinks”

Definition	A decrease in the frequency, size, consistency and ease of bowel movements, and the complaint depends upon the individual’s perception.

Prognosis	Depends upon the case, but most chronic cases can be managed adequately by good patient education, and minimal use of drugs.

Treatment	Bowel atony causing constipation is normal in old age. Patient must learn to accept it to some degree. Regular walking + Yogasanas to improve the tone of abdominal wall muscles. High fibre diet: Green vegetables, fruits, raw bananas. A glass of hot water in the morning, with 1-2 tsp of ghee. Avoid tobacco, mawa or smoking. Prescribe a laxative preferably bulk laxative. Isogel granules, 2 tsp stirred in water and swallowed immediately. Evacuol 1-2 tsp x bd Agarol 1-2 tsp HS Cremaffin 2tsp HS Tab. DULCOLAX 5mg x 2 HS. Do not give the same laxative for very long time. Change the drug frequently. Tab. Cisapide 10mg tds x 1-2 months Ayurvedic preparations are useful prolonged use Kayam churn 2 tsp HS Triphala churn 2 tsp HS Glycerine syringe or DULCOLAX suppository or simple soap water, enema, if drugs fails. If patient has alternate diarrhea and constipation, or if blood is mixed with stools ask for colonoscopy or Ba enema to rule out malignancy. Isogel granules Evacuol Agarol Cremaffin Tab. Cisapide Kayam churn Triphala churn DULCOLAX

General Measures	Dietary measures-Ensures adequate fibre intake.Ensure adequate fluid intake.Faecal impaction –Best treated with gentle digital disimpaction.

Advice to Patient	Explanation of bowel physiology in simple terms. Ensure adequate fibre intake in diet (fresh fruit, vegetables, cereals),Avoid white bread, rusks, banasa, grated apple, white rice and hard boiled eggs. Ensuring adequate hydration, especially in the immobilized and the very sick. Well people should take at least 2 litres of water daily, including a generous glass of water on an empty stomach. The edentulous should wear right sized dentures and should chew the food properly. Important of regular exercise. To sit on commode irrespective of ‘urge’ for 10-15 minutes half hour after breakfast. To adopt Indian style with thighs flexed on abdomen posture, on an Indian commode, as opposed to the bench type western toilet. If using a western toilet use a foot stool. Warn the dangers of cathartic colon in regular laxative users.

Follow Up	If problem persists, even in chronic case investigate for possible fresh organic cause.

Prevention	Reinforce in the patient’s mind the utility of simple measures like ensuring adequate dietary fibre, fluid intake and regular exercise.

Reference From	www.healthlink.mcw.edu/article/930592380.html

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