2. Question №. 1
1. I am 30 years old and my stool Frequency
decreased from three times per day to once
every two days:
Am I constipated?
What are the major
symptoms of constipation?
Faculty of Pharmacy - Alexandria University
(Egypt)
3. What is Constipation?
Decrease in the frequency in of fecal elimination.
Passage of hard, dry, sometimes painful stool.
From 3 times daily
to 3 times per week.
Normal Range
* So the patient is not constipated
Faculty of Pharmacy - Alexandria University
(Egypt)
4. Patient Counseling
Life Style causes of constipation:
1. Diet:
a) Inadequate fluid intake
Should drink at least 8 glasses of
non-caffeinated fluids daily.
Etiology
Faculty of Pharmacy - Alexandria University
(Egypt)
5. Patient Counseling
b) Inadequate dietary fibers
Diets include a good quantity of fibers are less likely
to suffer from constipation.
Fiber retains water, softening stool & ease
evacuation.
Foods low in fiber high fat food.
Foods rich in fiber fruits, veg. and whole grain.
Normal daily fiber intake 10 ̴ 25 g.■
Etiology
Faculty of Pharmacy - Alexandria University
(Egypt)
6. Patient Counseling
c) Inadequate exercises
Walking help prevent constipation by promoting
bowel motility.
d) Loss of defecatory reflex
If you ignore the urge to have
a bowel movement.
The urge can gradually go away.
The longer can you delay it,
the drier and harder stool will become.
Etiology
Faculty of Pharmacy - Alexandria University
(Egypt)
8. Question №. 2
1. My grandmother usually feels discomfort
from chronic constipation:
What are reasons for
this problem?
What are your advice?
Faculty of Pharmacy - Alexandria University
(Egypt)
9. Risk factors of
constipation
Age Gender
Epidemiology
• Constipation is common in
elderly people ( > 65 y.)
• Laxative abuse
• gut motility
• Medication use
• Poor nutrition
• Females are three times more
likely to suffer from constipation
than males
Faculty of Pharmacy - Alexandria University
(Egypt)
10. Your advice
1. Laxative abuse:
Lead to cathartic colon (loss of tone of
intestinal muscles) cause poor bowel function.
2. Increase intake fluids & fibers.
3. Increase exercise ( bowel tone).
Faculty of Pharmacy - Alexandria University
(Egypt)
11. Question №. 3
3. My wife is pregnant she is worried about
constipation, I would like to know:
What is the factors that
predispose pregnant to
constipation?
Faculty of Pharmacy - Alexandria University
(Egypt)
12. Factors which constipate pregnant
• Bowel hypo-motility
Progesterone
level
• Slowing down the passage
of food
Uterus compress
the intestine
• Reduce bowel activityLess exercise
• Can be constipatedVitamins intake
(Fe2+ , Ca2+ )
Faculty of Pharmacy - Alexandria University
(Egypt)
13. Question №. 4
4. Is there a relationship between
anal disorders as abscesses
and constipation?
Faculty of Pharmacy - Alexandria University
(Egypt)
14. Abscess
It is a collection of pus (dead neutrophils)
that has accumulated in a cavity formed by
the tissue.
Usually caused by bacteria or parasites
infection.
Faculty of Pharmacy - Alexandria University
(Egypt)
15. Perianal abscesses
Found in patients with inflammatory bowel
disease (Crohn's disease) or diabetes.
1
• Passage of hard stool
• Cause an internal wound
2
• The wound infected because of presence of feces in the rectal
area.
3
• Abscess is developed
4
• It presents as a lump of tissue near the anus
5
• By the time, it becomes larger and more painful
Faculty of Pharmacy - Alexandria University
(Egypt)
16. Question №. 5
5. I heard that there is a medical condition
called “Colonic inertia”:
What is it?
How diet can affect colonic
motility?
Faculty of Pharmacy - Alexandria University
(Egypt)
17. Colonic Inertia
Prolonged colon transit time
Colonic dysfunction
Prolong colon transit of the
fecal polus
More water absorption
Increase in its hardness
• The average time of passage through the GIT is 4 days.
Faculty of Pharmacy - Alexandria University
(Egypt)
18. Diet & Colonic motility
Motility may be stimulated by boosting
carbohydrates intake while limiting
protein.
Faculty of Pharmacy - Alexandria University
(Egypt)
19. Question №. 6
Is it true that some health
problems may lead to
constipation?
Faculty of Pharmacy - Alexandria University
(Egypt)
20. Pain
During defecation avoidance constipation.
Causes
1. Passage of hard stool.
2. Anal fissures and abscess.
3. Hemorrhoids.
Faculty of Pharmacy - Alexandria University
(Egypt)
21. Health problems may lead to
constipation
1. Carcinoma
2. Irritable bowel syndrome (IBS)
common cause in younger people
3. Diabetes
60% of diabetics patient
4. Renal failure
due to electrolyte & fluid disturbance
Faculty of Pharmacy - Alexandria University
(Egypt)
22. 5. Parkinsonism
up normal gut motility & rigid muscles
6. Colonic inertia
7. Pregnancy
Health problems may lead to
constipation
Faculty of Pharmacy - Alexandria University
(Egypt)
23. Iron vs. Constipation
Iron slow down the digestive system &
slowing of normal bowel movement.
This may be because iron is a metal in its
basic form.
Metals carry a charge that can affecting
muscles and nerves in the bowel
Faculty of Pharmacy - Alexandria University
(Egypt)
24. Drugs cause constipation
1. Narcotic analgesics
2. Diuretics
3. Anticonvulsants
4. Sympathomimetic or anticholinergic
5. Antihistaminic
6. Antacids (containing Ca2+,Al3+)
Faculty of Pharmacy - Alexandria University
(Egypt)
25. Purgaton®
tablet
Contain senna glycosides (anthraquinone)
With extended use cause lazy bowel
syndrome (atonic colon)
So bowel unable to move without chemical
stimulation.■
Faculty of Pharmacy - Alexandria University
(Egypt)