Bowel emptying disorders

From WikiLectures

Intestinal emptying disorders include constipation, encopresis, fecal incontinence, and diarrhea. The physiological frequency of bowel movements varies with age.

Constipation[edit | edit source]

Constipation is defined as the difficulty of emptying stiff stools and the inability to spontaneously defecate. This is partially subjective. It can be an isolated problem (dyschezia) or a symptom accompanying another disease (organic, secondary constipation). It is very important to distinguish organic constipation from functional constipation.[1]

Searchtool right.svg For more information see Constipation.
Searchtool right.svg For more information see Constipation (pediatrics).

Definition of constipation according to the Roman criteria II (1999)[edit | edit source]

Some of the following must apply:

  • less than 3 stools per week;
  • solid stool in more than 25% of defecations;
  • feeling of incomplete emptying in more than 25% of defecations;
  • the need for manual maneuvers to facilitate more than 25% of defecations (digital stool evacuation, pelvic floor support).[1]

Pathogenesis[edit | edit source]

Decreased water content in the stool, prolonged passage time through the digestive tract, and/or the presence of a mechanical barrier in the terminal part of the digestive tract contribute to constipation.[1]

Therapy[edit | edit source]

Regimen and dietary measures[edit | edit source]

  • Regular daily eating regime, sufficient fluid intake, and enough fiber in the diet (whole grains, fruits, vegetables).
  • Plenty of exercise, belly massage, and no laxatives.
  • Training of defecation reflex with the use of physiological gastrocolic reflex (after waking up a glass of water, usual morning tasks, breakfast, with an interval of 20–30 minutes attempted defecation).

Pharmacological treatment[edit | edit source]

Lactulose, saline laxatives, laxative minerals, enemas, drugs stimulating colonic motility.[1]

Supposed constipation[edit | edit source]

  • Improper judgement or psychological disorder.[2]

Pseudoobstruction[edit | edit source]

  • It occurs with low food intake.[2]

Encopresis[edit | edit source]

  • Involuntary bowel emptying (into clothes, to the floor)[2]

Soiling[edit | edit source]

  • involuntary leakage of stool in chronic constipation
  • stagnant stool in the rectum escapes
  • may be mistaken for diarrhea[2]

Stool incontinence[edit | edit source]

Diarrhea[edit | edit source]

Diarrhea can be characterized as frequent bowel movements. This is a symptom with considerable subjective variation. Diarrhea is a common manifestation of various digestive disorders. Diarrheal diseases cause up to 20 million deaths a year worldwide, with young children most at risk.[3]

Searchtool right.svg For more information see Diarrhea.
Searchtool right.svg For more information see Diarrhea (pediatrics).
Searchtool right.svg For more information see Therapy of diarrheal diseases.

Links[edit | edit source]

Reference[edit | edit source]

  1. a b c d KLENER, Pavel, et al. Vnitřní lékařství. 3. edition. Praha : Galén, 2006. pp. 608-609. ISBN 80-7262-430-X.
  2. a b c d BENEŠ, Jiří. Studijní materiály [online]. ©2007. [cit. 2009]. <>.
  3. KLENER, Pavel, et al. Vnitřní lékařství. 3. edition. Praha : Galén, 2006. pp. 610-613. ISBN 80-7262-430-X.

Literature[edit | edit source]

  • HRODEK, Otto – VAVŘINEC, Jan, et al. Pediatrie. 1. edition. Praha : Galén, 2002. ISBN 80-7262-178-5.
  • ŠAŠINKA, Miroslav – ŠAGÁT, Tibor – KOVÁCS, László, et al. Pediatria. 2. edition. Bratislava : Herba, 2007. ISBN 978-80-89171-49-1.