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Management of Patients With Intestinal and Rectal Disorders Part 4 2008. Miss Iman Shaweesh. Abnormalities of Fecal Elimination. Constipation
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Miss Iman Shaweesh
passage of the hard stool through the anus, tearing the lining of the anal canal.
day), and altered consistency (ie, looseness) of stool. It is usually associated with urgency, perianal discomfort, incontinence, or combination of these factors. Any condition that causes increased intestinal secretions, decreased mucosal absorption, or altered motility can produce diarrhea.
When the cause of the diarrhea is not obvious, the following diagnostic tests may be performed:
multiple sclerosis, diabetic neuropathy, dementia), inflammation, infection, radiation treatment, fecal impaction, pelvic floor relaxation, laxative abuse, medications, or advancing age (ie, weakness or loss of anal or rectal muscle tone).
Deficiency of intestinal lactase results in high concentration of intraluminal lactose with osmotic diarrhea
Toxic response to a gluten fraction by surface epithelium
results in destruction of absorbing surface
Bacterial invasion of intestinal mucosa
Hyperacidity in duodenum inactivates pancreatic enzymes
Decreased local intestinal defenses, lymphoid hyperplasia,
retained in a diverticulum produce infection and inflammation that can impede drainage and lead to perforation or abscess formation.
Diverticulitis is most common (95%) in the sigmoid colon. Approximately 20% of patients with diverticulosis have diverticulitis at some point.
localized, and more intense near the site of the inflammation. Movement usually aggravates it.
The affected area of the abdomen becomes extremely tender and distended, and the muscles become rigid. Rebound tenderness and paralytic ileus may be present. Usually, nausea and vomiting occur and peristalsis is diminished.
The temperature and pulse rate increase, and elevation of the leukocyte count.
striking similarities but also several differences.
adults but can appear at any time of life. It is more common in women, and it occurs frequently in the older population (between the ages of 50 and 80).
the rectum and spreads proximally to involve the entire colon. Eventually, the bowel narrows, shortens, and thickens because of muscular hypertrophy and fat deposits.
a liquid diet for a few days before radiography and a gentle tapwater enema on the day of the examination may be prescribed.Colonoscopy is contraindicated in severe disease because of the risk of perforation.
with a high mortality rate (15% to 50%)