Children A number of factors can alter a child's bowel habits, including unavailable toilet facilities; emotional distress; febrile illness: chronic medical conditions (e.g., cystic fibrosis and hypothyroidism); family conflict: dietary changes (e.g.. switching from human to cow's milk); or a change in daily routine or environment. Some children are poor or picky eaters, which may contribute to the development of constipation due to inadequate bulk and fluids in the diet. Constipation associated with an organic or pathologic etiology is uncommon in children." Bowel movement patterns vary widely in children; therefore constipation can be a complex problem that is often difficult to detect and manage. Selected Laxative Products Trade Name Primary Ingredients Bulk-Forming Laxatives Citrucel Powder Methylcellulose 2 g/tsp Citrucel Sugar Free Powder Methylcellulose 2 g/tsp FiberCon Tablets Calcium polycarbophil 625 mg Maltsupex Liquid Barley malt extract 750 mg/tsp Metamucil Fiber Wafer Psyllium hydrophilic mucilloid 3.4 g/2 wafers Metamucil Read more [...]

Bulk-Forming Laxatives Dietary fiber and bulk laxatives with adequate fluid intake are the most physiologic and safest of medical therapies. However, they may be counterproductive in patients with idiopathic slow transit constipation or with constipation associated with irritable bowel syndrome because they often worsen bloating and abdominal distension in these populations. Dietary Fiber Dietary fiber in cereals contain cell walls that resist digestion and retain water within their cellular structures, whereas those found in citrus fruits and legumes stimulate the growth of colonic flora and increase fecal mass. Wheat bran is the most effective fiber laxative with a clear dose response on fecal output. Patients with poor dietary habits may add 2 to 4 tablespoons of bran to each meal, followed by a glass of water or another beverage. A laxative effect may not be observed for 3 to 5 days. Patients should be cautioned that large amounts of bran can cause abdominal bloating or flatulence; therefore, they should start with small amounts and titrate slowly to the desired effect. Psyllium (Metamucil), Read more [...]

Rehydration The restoration and maintenance of adequate hydration is the most important component of the treatment of acute infectious diarrhea. Rehydration is particularly important in the elderly, pediatric, or immunocompromised patient. In otherwise healthy patients with mild to moderate diarrhea, increasing intake of most fluids is usually adequate to replace fluid losses. In moderate to severe diarrhea, however, fluids with appropriate electrolyte concentrations are needed. Water, juices, and sports drinks will not adequately replace electrolyte losses. For dehydrating diarrhea, aggressive oral rehydration with electrolyte solutions or intravenous (IV) fluids is required. The formulation of "oral rehydration solutions" (ORS), as determined by the World Health Organization (WHO), includes precise concentrations of sodium, potassium, chloride, citrate/bicarbonate, and glucose to replace fluid and electrolyte losses from diarrhea and avoid IV fluid administration. Commercial pediatric formulations are readily available (eg,Pedialyte).Ahome ORS recipe, based on WHO formulations, is available Read more [...]

A treatment for constipation is especially relevant for consumers that suffer on a regular basis or cannot bear attendant symptoms. For the overall health it is important to have a regular bowel movement. If a healthy diet, lots of exercise and common "cures" such as prunes and fluids require several days to take effect and sometimes don't work at all, it might be necessary to take a laxative to restore regularity. It sometimes might be necessary to visit the doctor to diagnose the cause of constipation. Diagnosis If warning signs exist, the doctor should be consulted. Numerous hormonal disturbances, metabolic disorders and various drugs can cause constipation. Metabolic disorders include diabetes mellitus, an under-active thyroid, reduced potassium or increased calcium levels in the blood. Drugs that can cause constipation include antihypertensive agents, cardiac drugs, iron tablets, antidepressants, hypnotics and diuretics. If these causes can all be ruled out, so-called functional disturbances of spontaneous intestinal motility are generally responsible in 80 to 90 percent of cases. Read more [...]

Q: Our 3-year-old boy has had a problem with constipation. His doctor has checked him out and didn't find anything unusual. He recommends giving him one to two teaspoons of mineral oil in orange juice at bedtime to ease the constipation. My questions are: What's causing this problem? Are there any other options for treatment? If I give our son mineral oil repeatedly, do we run the risk of lazy bowels? Is there any basis to claims that mineral oil inhibits the body's ability to process vitamins? A: The first step is to make sure that all you're dealing with is simple constipation, which is a common problem in young children. Then you can decide what treatment to use. One of the most common causes of constipation is lack of adequate fiber or water in the diet. Another common cause is irregular bowel habits, sometimes stemming from painful bowel movements. For example, if your child becomes constipated for any reason and has a hard time moving his bowels, he may develop an anal fissure -- a small tear in the anal opening. This painful condition will make him not want to move his bowels, which Read more [...]

Q. I occasionally have a problem with constipation, and fortunately it usually clears up by itself. But if I ever should need to take something for it, what should I take? I've noticed all kinds of laxatives, stool softeners and other treatments for constipation at the drug store, but I'm not sure what works best. Also, should I ever be concerned about what's causing the constipation? A.Many people have constipation from time to time, and it's usually not a sign of anything wrong. Every now and then, however, it can be a clue to an underlying problem with your intestines, even something as serious as cancer. So if your constipation is severe or persistent, check with your doctor to make sure nothing serious is going on. Oddly enough, there's no universally accepted definition of constipation. For some people, it means moving your bowels less often than usual; for some it means having painful or difficult bowel movements. And for others, it's both. Even excluding serious problems, there can be many reasons why you're constipated. These include being inactive, not drinking enough fluids 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 [...]

Constipation is defined as the difficulty of passing stools, incomplete passage, or infrequent passage of hard stools. It can be further defined as having less than three stools per week for women and five for men despite a high residual diet, or a period greater than 3 d without a bowel movement. It can be caused by gastrointestinal disorders, metabolic and endocrine disorders, pregnancy, neurogenic and psychogenic problems, or it could be drug induced. Laxative Mechanisms of Action Laxatives promote bowel evacuation by decreasing water and electrolyte absorption, increasing intraluminal osmolarity, or increasing hydrostatic pressure in the gut. Chronic use of laxatives, particularly stimulants, may lead to laxative dependency. Laxative dependency, in turn, may result in fluid and electrolyte imbalances, steatorrhea, osteomalacia, and vitamin and mineral deficiencies. Known as laxative abuse syndrome (LAS), it is difficult to diagnose. Laxative abuse syndrome is often seen in women with anorexia nervosa, depression, and personality disorders and also in elderly patients with quasimedical concerns Read more [...]

IBS — Irritable Bowel Syndrome Diagnosis and Definition Irritable bowel syndrome (IBS) is a common chronic intestinal disorder characterized by abdominal discomfort and altered bowel habits. These symptoms occur in the absence of "structural or biochemical abnormalities." It is estimated that up to 20% of the population of the United States has symptoms suggestive of IBS. Multiple comorbidities, the high cost of medical utilization, and diminished productivity and quality of life all may be found in association with irritable bowel syndrome. Despite extensive research, there is no specific test that can diagnose this condition. In clinical practice, a diagnosis of IBS is accomplished after performing a careful medical history, including a system assessment using established diagnostic criteria, a complete physical examination, and limited laboratory testing. A flexible sigmoidoscopy or colonoscopy is often suggested; the choice of these evaluations depends on the age and risk factors of the individual patient. The clinician must carefully assess the patient for any signs and symptoms of organic Read more [...]

Constipation is commonly defined as the paucity of bowel movements. However, patients may have constipation regardless of the number of bowel movements in a unit of time. The inability to satisfactorily evacuate one's colon and rectum can be manifested by different degrees of abdominal discomfort associated with "normal" bowel habits, infrequent stools, or even overflow diarrhea. In addition, many other abdominal complaints are related to constipation, including pain syndromes, bloating, fullness, and even heartburn and dyspepsia. It is not unusual for patients referred for constipation to present to the specialist having had at least one (and possibly multiple) full anatomic evaluation(s) of the bowel, including computed tomography (CT) scans, contrast studies, and colonoscopies. The reported results of these studies are usually normal, except for varying degrees of diverticulosis coli. Usually, a careful history suffices to reveal the underlying problem. Issues to be addressed in the history include bowel habits, frequency of bowel movements, ease or difficulty with evacuation, chronicity, Read more [...]