Monroe Community Hospital "Effects of Dietary Fiber - LiquaFiber™ - on Replacing Bowel Medications and Psyllium Fiber use in Long Term Care Residents" This clinical trial was performed at Monroe Community Hospital in Rochester, New York. Monroe Community Hospital is a 560-bed long-term care facility that has a unique patient mix. The facility has residents of all ages, from children as small as infants to the elderly. The facility boasts one of the finest Alzheimer's units in the country and has a high speed transitional care unit that offers wonders in a variety of therapies. This study began on March 1st and ran until April 20th . Problem Like most long- term care facilities MCH faces the everyday problems associated with constipation and bowel management. One of the contributing factors is the difficulty of patients obtaining the Recommended Daily Allowance of fiber. The products available require large amounts of liquid to be ingested which is very difficult for residence to consume on a consistent basis. The patients are afflicted with taste fatigue and refuse the treatment, hence Read more [...]

Colon and Rectal Care Center Is there a preparation? Yes! Although preparations differ, all require you to be on a liquid diet for at least one full day prior to your examination. You will also need to pick up the medication listed on your preparation about one week prior to your procedure. If you do not prep, the colonoscopy cannot be done. What about my medications? 1. Stop taking aspirin (except for baby aspirin), anti-arthritis medication, Ibuprofen or blood thinning drugs seven days before the day of your colonoscopy. Check with the prescribing doctor prior to stopping these drugs. Notify us if you take Coumadin, Plavix or Aspirin by calling 317-841-8090 extension 229. You may take Tylenol. 2. Do not take iron, herbal supplements or vitamin E seven days prior to the exam. You may continue taking multi-vitamins including those containing iron until the day of your procedure. 3. If you take more than 500 mg of vitamin C per day, you must continue to take the vitamin C every day, including the day of your colonoscopy. 4. Do not take any insulin or anti-diabetic medication on the Read more [...]

Palo Alto Medical Foundation A Sutter Health Affiliate Constipation is a common problem experienced by many patients and can be caused by chemotherapy, radiation, surgery, stress, or medications. Please do not be afraid or embarrassed to call your doctor or nurse at any time; if left untreated the constipation may get worse and not improve on its own. Many chemotherapy and anti-nausea medications cause constipation, so when starting chemotherapy take a stool softener like Ducosate every day unless otherwise directed. You must drink plenty of fluids when taking any laxatives for them to work effectively. Over the counter medication management of constipation: To prevent constipation or to soften hard stools start: If your stools are still hard after taking Colace for two days: If your stools are still hard after increasing Colace for two days: Take Colace® (generic name is Ducosate) stool softener 10Omg once in the evening. Increase the Colace® to twice a day. Continue taking the Colace® to twice a day. Add Senokot® (generic name is Senna) laxative 1-2 tablets Read more [...]

CSA – Cheboygan Surgical Associates Definition Small, hard stools. Bowel movements (B.M.'s) may be infrequent and passing them may be difficult, painful or impossible. You may also have bloating or cramping. • Mild Constipation: no bowel movements for 1-2 days longer than usual • Moderate Constipation: no bowel movements for 2-3 days longer than usual • Severe Constipation: no bowel movements for 4-5 days longer than usual Causes Disease, side effects of treatment, decreased activity, lack of liquid in the diet and emotional stress can all cause constipation. Constipation is also caused by medications, such as: Darvocet Duragesic Patch Norco Tylenol #3 & #4 Darvon Kytril Percocet Tylox Demerol Lortab Percodan Vicodin Dilaudid Morphine Sulphate Roxanol Zofran Duramorph M.S. Contin Roxicet Prevention If possible, try to increase the amount of liquids you drink. Make some dietary changes, such as increasing fruits, vegetables and bran, and decrease starchy foods such as white bread, cakes and cheese. Many people find hot Read more [...]

• define the term diarrhea; • describe the causes of diarrhea and the organisms frequently associated with traveller's diarrhea; • discuss the drug treatments used in diarrhea and their mechanisms of action; • describe the actions of intestinal flora. Sixty-year-old Mrs Kaye was a very healthy lady who never missed her daily walk to the park and went swimming twice a week. She had never experienced any health problems, except occasional indigestion, for which she usually took ranitidine. Sadly, a year ago she lost her husband, who died quite suddenly. Mrs Kaye sold her house and moved in with her daughter and two grandchildren. She decided to take them all abroad for the first time, to enjoy a package holiday in the sun. Everybody was having an enjoyable time; however, two days before coming back home, Mrs Kaye developed acute diarrhea. Her daughter took her to a local medical centre and Mrs Kaye was prescribed loperamide hydrochloride. She had a rather uncomfortable few days but recovered soon after returning home. What do you understand by the term diarrhea? A basic definition Read more [...]

• outline the defecation reflex; • describe the factors that contribute to the development of constipation; • discuss the pharmacological management of constipation; • outline the side effects associated with the use of laxatives. Mr Benjamin is a 75-year-old man with no close relatives who has lived alone since he lost his wife three years ago. He has become increasingly frail over the past two years. He cooks infrequently, eats little fruit and almost no vegetables. Mr Benjamin rarely visits his friends or the shops; if he goes for a walk, it is a short one, as he is now frightened of the traffic. He has severely restricted his intake of fluids in the evening and has even cut out his cup of hot milk before bed, as he does not want to visit the toilet during the night. Mr Benjamin has never had any gastrointestinal complaints in the past, but recently he has not opened his bowels for more than two weeks. His doctor has advised him to drink more fluids and has prescribed lactulose. Describe the normal process of defecation. Faecal material usually remains in the colon for Read more [...]

Mr Radcliffe is an elderly man who lives alone. Today, his home help asks what you can recommend for diarrhoea, from which Mr Radcliffe has been suffering for 3 days. He has been passing watery stools quite frequently and feels rather tired and weak. He has sent the home help because he dare not leave the house and go out of reach of the toilet. You check your PMRs (patient medication records), which confirm your memory that he takes several different medicines: digoxin, furosemide and paracetamol. Last week you dispensed a prescription for a course of amoxicillin. The home help tells you that he has been eating his usual diet and there does not seem to be a link between food and his symptoms. The pharmacist's view Mr Radcliffe's diarrhoea may be due to the amoxicillin, which he started to take a few days ago. It would be best to call the patient's doctor to discuss the appropriate course of action because Mr Radcliffe's other drug therapy means that fluid loss and dehydration may cause electrolyte imbalance and put him at further risk. The doctor may decide to stop the amoxicillin. The doctor's Read more [...]

Mrs Jean Berry wants to stock up on some medicines before her family sets off on their first holiday abroad; they will be going to Spain next week. Mrs Berry tells you that she has heard of people whose holidays have been ruined by holiday diarrhoea and she wants you to recommend a good treatment. On questioning, you find out that Mr and Mrs Berry and their two boys aged 10 and 14 years will be going on the holiday. The pharmacist's view Holiday diarrhea can often easily be dealt with. Mrs Berry could be advised to buy some loperamide capsules, which would be suitable treatment for her, Mr Berry and their 14-year-old son. In addition, she should purchase some oral rehydration sachets for the younger son. The sachets could also be used by other family members. The pharmacist could also give some valuable advice about the avoidance of potential problems by the Berry family on their first foreign holiday. Fresh fruit should be peeled before eating and hot food should not be eaten other than in restaurants. Roadside snack stalls are best avoided. The question of the quality of drinking water often Read more [...]

Mrs Choudry is collecting her regular repeat prescription for antihypertensive treatment. You ask how she and the family are, and she tells you that several members of the family have been suffering with diarrhea on and off. You know that the family recently returned from a trip to India where they had been visiting relatives to attend a family wedding. In answer to your questions, Mrs Choudry tells you that the problem with the diarrhoea started after they returned. The pharmacist's view Referral to the GP is needed here as the diarrhea may be related to the recent travel. The doctor's view Referral is a sensible course of action. Clearly, more information is required, e.g. date of onset of symptoms and date of return to the UK. It does not sound as if any of the family are acutely ill but it would be necessary to ensure that no one is dehydrated. If the diarrhea is persisting, it would be helpful to send stool samples to the local public health laboratory for analysis. It is possible that they may be suffering from giardiasis, which can be treated with metronidazole. Sometimes stool samples Read more [...]

Mrs Robinson asks what you can recommend for diarrhea. Her son David, aged 11 years, has diarrhoea and she is worried that her other two children, Natalie, aged 4 years, and Tom, aged just over 1 year, may also get it. David's diarrhoea started yesterday; he went to the toilet about five times and was sick once, but has not been sick since. He has griping pains, but is generally well and quite lively. Yesterday he had pie and chips from the local takeaway during his lunch break at school. No one else in the family ate the same food. Mrs Robinson has not given him any medicine, but has some kaolin and morphine mixture at home and wants to know if David could take some, and also if the other children could take it if necessary. The pharmacist's view It sounds as if David has a bout of acute diarrhea, possibly caused by the food he ate yesterday during lunchtime. He has vomited once, but now the diarrhoea is the problem. The child is otherwise well. He is 11 years old, so the best plan would be to start oral rehydration with some proprietary sachets, with advice to his mother about how they should Read more [...]