Transcript constipation

Pharmaceutical guidelines of
patients with pathology of
digestive organs.
SYMPTOMATIC TREATMENT
OF CONSTIPATION
CONSTIPATION
• Violation of bowel function, reflected in
increasing intervals between acts of
defecation (more than 48 hours)
compared with individual physiological
norm or systematically inadequate stool
CONSTIPATION
• Constipation occurs when bowel movements
become difficult or less frequent.
• Some people have bowel movements three
times a day; others, only one or two times a
week.
• Going longer than three days without a bowel
movement is too long. After three days, the
stool or feces become harder and more
difficult to pass.
CONSTIPATION
•
•
•
•
The patient is considered constipated if
have two or more of the following for at
least 3 months:
Straining during a bowel movement more
than 25% of the time.
Hard stools more than 25% of the time.
Incomplete evacuation more than 25% of the
time.
Two or fewer bowel movements in a week.
Common causes of constipation
• Inadequate water intake.
• Inadequate fiber in the diet.
• A disruption of regular diet or routine;
traveling.
• Inadequate activity or exercise or immobility.
• Eating large amounts of dairy products.
• Stress.
• Resisting the urge to have a bowel movement,
which is sometimes the result of pain from
hemorrhoids.
• Overuse of laxatives (stool softeners) which,
over time, weaken the bowel muscles.
Common causes of constipation
(cont’d)
• Hypothyroidism.
• Neurological conditions such as Parkinson's disease
or multiple sclerosis.
• Antacid medicines containing calcium or
aluminum.
• Medicines (especially strong pain medicines, such
as narcotics, antidepressants, or iron pills).
• Depression.
• Eating disorders.
• Irritable bowel syndrome.
• Pregnancy.
• Colon cancer.
Symptoms of constipation
• Infrequent bowel movements and/or
difficulty having bowel movements.
• Swollen abdomen or abdominal pain.
• Vomiting.
Threatening symptoms of
constipation
• blood in stool
• weight loss
• severe pain with bowel movements
• constipation has lasted more than two
weeks
• fever
• sharp abdominal distention
Blood in a bowel movement
• Bright red blood is usually from hemorrhoids
or tears in the anal lining called fissures.
Constipation and straining during bowel
movements can be the cause.
• Maroon or tarry black blood or clots usually
mean bleeding is coming from higher in the
gastrointestinal tract. The cause may be more
serious.
Treatment
The success of the treatment of
constipation is made up of three components:
-the degree of completeness of identification
and elimination of the causes of delay in stool
-patient readiness to change lifestyle, dietary
habits, the recommendations of the physician
and the pharmacist (compliance)
-availability of doctors and pharmacists to
perform a comprehensive, individual
treatment of each patient
Treatment Choices for
Occasional Constipation
• It is recommended that the regular menu be filled with
plenty of fiber rich foods such as fresh fruits and
lubricated as it passes through the intestine vegetables,
fruit juices, whole grain products, and others.
• to increase fluid intake which ensures that the waste
material is perfectly.
• minimize, if possible avoid, taking foods that can cause
dehydration such as alcohol, caffeine, and salty foods.
• Experts recommend at least eight glasses of water daily
to fuel body’s demand for liquid as well as to maintain
the fluidity of stool.
• physical activity can also contribute in experience of
constipation. Exercise plays a huge role in the whole
course of acute constipation treatment. Without it, the
full effect of the treatment is not achieved.
• This small, dried fruit has
earned a big reputation as
"nature's remedy" for
constipation. Prunes (often
called dried plums) can
prevent or improve
constipation symptoms.
They're packed with
insoluble fiber, as well as the
natural laxatives sorbitol and
dihydrophenylisatin. The
soluble fiber found in prunes
may help lower cholesterol.
And they're safe for longterm consumption. Children
who don't like prunes might
eat prune juice ice pops or
sip prune juice mixed with
another juice to disguise the
taste.
Recommendations
• Lack of physical activity
can contribute to
constipation. Exercise,
however, can help make
bowel movements more
regular and can reduce
stress ( at least an hour
after eating a big meal
before exercise). It is
recommended a 10- to 15minute walk several times
a day. Stretching and yoga
can also help constipation.
Recommendations
• coffee and other
diuretics such as
alcohol and
caffeinated tea and
cola should be
avoided
Constipation herbal remedies
• Aloe vera has been used since the olden
times. It is recommended that people
suffering from constipation take aloe vera
juice or aloe vera gel to avail of its
laxative properties.
• recommends flaxseed or linseed as a
great alternative for constipation
treatments. Herbalists recommend taking
three tablespoons of crushed or whole
flaxseed at least three times throughout
the day. This offers an effective treatment
for chronic constipation. To complement
the effects of flaxseed, it is need to drink
enough amounts of liquids right after
taking this herbal supplement. Fluids will
aid the movement of the flaxseed and
bowel contents through the digestive
system.
If conventional acute
constipation treatment is not
effective
• Fiber supplements (in combination with any
beverage or favorite foods)
• side effects - diarrhea and stomach cramps.
• Over-the-counter laxatives are also available
if that fiber supplements are not effective.
These products provide an immediate result
but it needs to be used in moderation.
• Enema is another acute constipation
treatment
• should be used very carefully and is reserved
for specific conditions.
• Enemas and colon irrigation
(high colonics) may
temporarily remove body
waste, but they're not an
effective way to prevent or
cure constipation. Enemas
can actually cause
constipation in older people
who get them regularly.
Colonic irrigation, which is
usually done by colonic
hygienists or therapists, can
damage the colon and can
lead to other issues.
Over-the-counter laxatives
• A suppository might work within an hour.
• It is needed to take a bulk-forming fiber
product every day for several days to see
results.
• Most over-the-counter laxatives are meant for
short-term use
• Overuse can lead to other digestive problems.
Laxatives
• Stool softeners prevent constipation by
allowing stools to absorb more water from
the colon. They prevent feces from hardening
-- softer stools are easier to eliminate from the
body. Like other laxatives, stool softeners
should be taken for short-term relief.
• In some cases, doctors prescribe stool
softeners for people such as surgery patients,
who may need to avoid straining during
bowel movements. Some preparations
combine a stool softener with a stimulant
laxative to activate bowel movements.
Castor oil
• Castor oil is a powerful laxative. But like
other laxatives, it should not be used longterm. Overusing laxatives can hurt body's
ability to absorb nutrients and some
medications.
• Castor oil can damage the bowel muscles,
nerves, and tissue if overused -- all of which
can cause constipation. Uses only with a
doctor's guidance.
Constipation & age
• Older people are more likely to become
constipated. This can be because of medical
conditions, poor nutrition, greater use of
medications, or not enough physical activity.
• Constipation is usual during pregnancy or
after childbirth or surgery.
• Pregnant women for relieving constipation
should check with your doctor
An excellent pregnancy constipation remedy is
lifestyle change. This is the safest and simplest
way of dealing with the discomforts associated
with pregnancy constipation
• Exercise is a crucial part of any pregnancy
constipation remedy.
• The body requires six to eight glasses of
water daily to prevent constipation. This
may not even be enough for pregnant
women because of their increased
demands. Avoid caffeinated beverages
and soft drinks as they can cause
dehydration. Some of the better choices
are herbal teas, vegetable juice, clear
soups and fruit juices. All of these provide
liquid at the same time fiber.
• A high fiber diet will make bowel content
bulkier. Some of the best food products
include fresh fruits, vegetables and whole
grains.
Pharmaceutical application for
guardianship of laxatives
• Laxatives containing anthraglycosides, act
within 8-12 hours after ingestion
• They are not used for spastic constipation,
because they can cause pain in the colon
• Anthraquinone glycosides pass into breast
milk, so that preparations containing them
should not be administered to nursing
mothers
• These drugs are not recommended to use
long-term
Pharmaceutical application for
guardianship of laxatives
(cont’d)
• The use of sodium pikosulfate infants is
ineffective
• With prolonged use of vaseline oil reduces
absorption of fat-soluble vitamins (A and D)
and an increased risk of malignant tumors in
the gastrointestinal tract
• Castor oil has a laxative effect in 5-6 hours
• When you receive laxatives containing fibers,
should drink per day for at least 1.5 liters of
fluid