Management-of-Constipation-in-Adults便秘的人管理22张课件

ManagementofConstipationinAdults便秘的人管理ManagementofConstipationinAdults便秘的人管理ManagementofConstipationinAdults便秘的人管理ManagementofConstipationinAdultsStephenAglubat,MDMay2012ObjectivesDefineConstipationTreatmentoptionsforconstipationManagementofConstipationin1ManagementofConstipationinAdultsStephenAglubat,MDMay2012ManagementofConstipationin2ObjectivesDefineConstipationTreatmentoptionsforconstipationObjectivesDefineConstipation3Case76yearoldfemalewithPMHxofHTN,DMII,HLD,presentstotheclinic.She’scomplainingofhavingstoolsonlytwiceaweek,andfeeling“full.”She’seatingmorevegetables,starteddrinkingmorewater,andsherecentlyincludedMetamuciltoherdiet.Herlastcolonoscopyoneyearagowasclean.Shecomestoyourofficetobeevaluatedforherconstipation.Whatwouldyouofferherfortheconstipation?A.LactuloseB.SennaC.DocusateD.WeeklytapwaterenemasCase76yearoldfemalewithPM4DefinitionRomeIIIcriteria:2ofthebelowdefinesconstipationStrainingLumpyHardStoolsIncompleteEvacuationUseofDigitalRectalManeuversSensationofAnorectalBlockage<3BowelMovementsperweekDefinitionRomeIIIcriteria:25PathophysiologyIConstipationiscausedby:PrimaryColorectaldysfunctionSlowTransitDyssnerygicDefacationIrritableBowelSyndromePathophysiologyIConstipation6PathophysiologyIIConstipationiscausedby:SecondaryCausesEndocrine/MetabolicNeurologicMyogenicDisordersMedicationsObstructionChronicIdiopathicConstipation(CIC)PathophysiologyIIConstipation7Management-of-Constipation-in-Adults便秘的人管理22张课件8ManagementInitialtreatmentofChronicFunctionalConstipationLifestylemodificationDietandfiberManagementInitialtreatmentof9LifestyleModificationsIncreasedfluidintakeExerciseEstablishregularbowelregimenpatternLifestyleModificationsIncreas10DietandfiberFiberincreasesbulk/distensionDistentioncausesstoolpropulsion.>25goffiber/dayEffectmaytakeweeks.Adverseeffects:Bloating,flatulenceDietandfiberFiberincreases11LaxativesIStimulantLaxativesSennaBisacodylLaxativesIStimulantLaxatives12LaxativesIIBulkforminglaxativesPsyllium(Metamucil)Methylcellulose(Citrucel)Polycarbophil(FiberCon)Dextran(Benefiber)LaxativesIIBulkforminglaxat13LaxativesIIIOsmoticLaxativesPolyethyleneglycolLactuloseSorbitolMagnesiumHydroxideLaxativesIIIOsmoticLaxatives14OthertherapiesColonicsecretagoguesLubipristoneOthertherapiesColonicsecreta15Management-of-Constipation-in-Adults便秘的人管理22张课件16SummaryConstipationintheolderadultmaybeduetochronicconstipation,secondaryetiologicfactorsAthoroughhistorymustbeobtainedtoruleoutsecondarycauses.Therapyincludes:Diet/lifestyleStimulantLaxativesOsmoticLaxativesSummaryConstipationintheold17Case76yearoldfemalewithPMHxofHTN,DMII,HLD,presentstotheclinic.She’scomplainingofhavingstoolsonlytwiceaweek,andfeeling“full.”She’seatingmorevegetables,starteddrinkingmorewater,andsherecentlyincludedMetamuciltoherdiet.Herlastcolonoscopyoneyearagowasclean.Shecomestoyourofficetobeevaluatedforherconstipation.Whatwouldyouofferherfortheconstipation?A.LactuloseB.SennaC.DocusateD.WeeklytapwaterenemasCase76yearoldfemalewithPM18Case76yearoldfemalewithPMHxofHTN,DMII,HLD,presentstotheclinic.She’scomplainingofhavingstoolsonlytwiceaweek,andfeeling“full.”She’seatingmorevegetables,starteddrinkingmorewater,andsherecentlyincludedMetamuciltoherdiet.Herlastcolonoscopyoneyearagowasclean.Shecomestoyourofficetobeevaluatedforherconstipation.Whatwouldyouofferherfortheconstipation?A.LactuloseB.SennaC.DocusateD.WeeklytapwaterenemasCase76yearoldfemalewithPM19References1.Managementofchronicconstipationinolderadults.Wald,Arthur.Uptodate.March2012References1.Managementofchr20谢谢你的阅读知识就是财富丰富你的人生谢谢你的阅读知识就是财富21

1、最灵繁的人也看不见自己的背脊。——非洲

2、最困难的事情就是认识自己。——希腊

3、有勇气承担命运这才是英雄好汉。——黑塞

4、与肝胆人共事，无字句处读书。——周恩来

5、阅读使人充实，会谈使人敏捷，写作使人精确。——培根

1、最灵繁的人也看不见自己的背脊。——非洲

2、最困22ManagementofConstipationinAdults便秘的人管理ManagementofConstipationinAdults便秘的人管理ManagementofConstipationinAdults便秘的人管理ManagementofConstipationinAdultsStephenAglubat,MDMay2012ObjectivesDefineConstipationTreatmentoptionsforconstipationManagementofConstipationin23ManagementofConstipationinAdultsStephenAglubat,MDMay2012ManagementofConstipationin24ObjectivesDefineConstipationTreatmentoptionsforconstipationObjectivesDefineConstipation25Case76yearoldfemalewithPMHxofHTN,DMII,HLD,presentstotheclinic.She’scomplainingofhavingstoolsonlytwiceaweek,andfeeling“full.”She’seatingmorevegetables,starteddrinkingmorewater,andsherecentlyincludedMetamuciltoherdiet.Herlastcolonoscopyoneyearagowasclean.Shecomestoyourofficetobeevaluatedforherconstipation.Whatwouldyouofferherfortheconstipation?A.LactuloseB.SennaC.DocusateD.WeeklytapwaterenemasCase76yearoldfemalewithPM26DefinitionRomeIIIcriteria:2ofthebelowdefinesconstipationStrainingLumpyHardStoolsIncompleteEvacuationUseofDigitalRectalManeuversSensationofAnorectalBlockage<3BowelMovementsperweekDefinitionRomeIIIcriteria:227PathophysiologyIConstipationiscausedby:PrimaryColorectaldysfunctionSlowTransitDyssnerygicDefacationIrritableBowelSyndromePathophysiologyIConstipation28PathophysiologyIIConstipationiscausedby:SecondaryCausesEndocrine/MetabolicNeurologicMyogenicDisordersMedicationsObstructionChronicIdiopathicConstipation(CIC)PathophysiologyIIConstipation29Management-of-Constipation-in-Adults便秘的人管理22张课件30ManagementInitialtreatmentofChronicFunctionalConstipationLifestylemodificationDietandfiberManagementInitialtreatmentof31LifestyleModificationsIncreasedfluidintakeExerciseEstablishregularbowelregimenpatternLifestyleModificationsIncreas32DietandfiberFiberincreasesbulk/distensionDistentioncausesstoolpropulsion.>25goffiber/dayEffectmaytakeweeks.Adverseeffects:Bloating,flatulenceDietandfiberFiberincreases33LaxativesIStimulantLaxativesSennaBisacodylLaxativesIStimulantLaxatives34LaxativesIIBulkforminglaxativesPsyllium(Metamucil)Methylcellulose(Citrucel)Polycarbophil(FiberCon)Dextran(Benefiber)LaxativesIIBulkforminglaxat35LaxativesIIIOsmoticLaxativesPolyethyleneglycolLactuloseSorbitolMagnesiumHydroxideLaxativesIIIOsmoticLaxatives36OthertherapiesColonicsecretagoguesLubipristoneOthertherapiesColonicsecreta37Management-of-Constipation-in-Adults便秘的人管理22张课件38SummaryConstipationintheolderadultmaybeduetochronicconstipation,secondaryetiologicfactorsAthoroughhistorymustbeobtainedtoruleoutsecondarycauses.Therapyincludes:Diet/lifestyleStimulantLaxativesOsmoticLaxativesSummaryConstipationintheold39Case76yearoldfemalewithPMHxofHTN,DMII,HLD,presentstotheclinic.She’scomplainingofhavingstoolsonlytwiceaweek,andfeeling“full.”She’seatingmorevegetables,starteddrinkingmorewater,andsherecentlyincludedMetamuciltoherdiet.Herlastcolonoscopyoneyearagowasclean.Shecomestoyourofficetobeevaluatedforherconstipation.Whatwouldyouofferherfortheconstipation?A.LactuloseB.SennaC.DocusateD.WeeklytapwaterenemasCase76yearoldfemalewithPM40Case