Constipation chronic

B. Gastrointestinal effects include nausea and vomiting (acute ingestion) and anorexia and constipation (chronic use). 

Use Alstonia extracts are used in traditional medicine for treatment of malaria, febrile attacks, constipation, chronic diarrhea, and dysentery. 

Celiac Disease. A disturbance of the lower gastroiatestiaal tract, celiac disease is a chronic disease characterized by loss of appetite and weight, depression and irritabiUty, and diarrhea frequendy followed by constipation (35). One of the more disturbiag features of ceHac disease is the large, frothy, foul-smelling stools. The disease may develop ia childhood or later ia life. Frequendy, the patients who develop the disease ia adulthood report having had some of the symptoms duting childhood. 

Workers who produce or use lead should be aware of possible ha2ards. Symptoms of chronic lead poisoning include fatigue, headache, constipation, uneasy stomach, irritabiHty, poor appetite, metallic taste, weight loss, and loss of sleep. Most of these same symptoms also occur in many common illnesses, such as the flu, thus a physician must rely on tests, such as blood lead analysis, to determine chronic lead poisoning. 

Balantidiasis in humans is manifest by chronic episodes of intermittent diarrhea and constipation, symptoms similar to those of amebiasis. The patient may also have abdominal pain, tenderness over the colon, anorexia, nausea, severe weight loss, and weakness. The disease may be fatal and, before the avakabihty of a treatment, was the cause of death in approximately 30% of infected individuals. 

Compare the features of chronic constipation with those of constipation-predominant irritable bowel syndrome (IBS). 

Chronic constipation exists when symptoms last for at least 3 months. 

Tegaserod maleate (Zelnorm) is a partial serotonin (5-HT4) receptor agonist that causes an increase in peristaltic activity and intestinal secretion and moderation of visceral sensitivity. It increases the frequency of bowel movements and reduces abdominal discomfort, bloating, and straining. It is indicated for the treatment of patients younger than 65 years of age who experience chronic idiopathic constipation. The most common adverse effects include headache, abdominal pain, diarrhea, and nausea. 

Lubiprostone (Amitiza), a bicyclic acid oral agent, is approved for treatment of chronic idiopathic constipation in adults. It has not been studied in children. Lubiprostone acts locally on intestinal chloride channels and increases intestinal fluid secretion, resulting in increased intestinal motility and thereby increasing the passage of stool.6... 

Slow-transit constipation can be treated with chronic administration of osmotic laxatives. Tegaserod maleate 6 mg orally twice daily is an acceptable treatment. Senna, bisacodyl, and other stimulants should be used only when the others fail to deliver the desired effect. 

Develop a plan to assess the effectiveness of laxative use in cases of chronic constipation. 

IBS-C can often be distinguished from chronic constipation primarily by the presence of abdominal pain and discomfort. Although pain and discomfort may be present in some patients with chronic constipation, it is an expected feature of IBS. 

Brandt L, Schoenfeld P, Prather C, et al. American College of Gastroenterology Functional Gastrointestinal Disorders Task Force. An evidence based approach to the management of chronic constipation in North America. Am J Gastroenterol 2005 100 S1-S21. 

Muller-Lissner SA, Kamm MA, Scarpignato C, Wald A. Myths and misconceptions about chronic constipation. Am J Gastroenterol 2005 100 232-242. 

Hydroxyurea is an oral drug that inhibits ribonucleotide reductase, which converts ribonucleotides into the deoxyribuon-cleotides used in DNA synthesis and repair. The time to peak concentrations of hydroxyurea is 1 to 2 hours after oral administration. Approximately 50% is degraded by the liver to form urea and respiratory carbon dioxide. The remainder is excreted by the kidney. The half-life ranges from 3.5 to 4.5 hours. Hydroxyurea has shown clinical activity in the treatment of chronic myelocytic leukemia, polycythemia vera, and thrombocytosis. The major side effects are myelo-suppression, nausea and vomiting, diarrhea, and constipation. Rash, mucositis, and renal tubular dysfunction occur rarely. 

Acute physiological responses to opiate administration occur rapidly and include constricted pupils, decreased pulse rate, reduced body temperature, slowed respiration rate and impaired reflexes. In addition, there is a marked slowing of the digestive system through an altering of the tonus and motility of the stomach and intestines, allowing for greater water absorption. This last effect is not subject to tolerance, and constipation is a common side effect even for chronic users. Indeed, some report that this is the worst side effect of opiate use. 

C. R., Colonic motility in man features in normal subjects and in patients with chronic idiopathic constipation, Am. J. Gastroenterol. 1999, 94, 1760-1770. 

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