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Is the constipation acute or chronic? If the constipation is acute and there is abdominal pain or vomiting, one must consider the possibility of intestinal obstruction ... DIAGNOSTIC WORKUP
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Is there a history of alcohol or drug ingestion? Alcohol and many drugs such as digitalis, aspirin, nonsteroidal anti-inflammatory agents, antihypertensives, and ... DIAGNOSTIC WORKUP
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Constipation is a common complaint that must be accurately defined by the patient before initiating an extensive evaluation. Constipation may include fewer than three bowel movements (BMs) in a week, excessive straining... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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Decreased bowel sounds can be as innocent as a hungry patient anticipating a next meal or as ominous as an impending abdominal catastrophe necessitating emergent laparotomy. However,... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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Despite extensive efforts to evaluate and classify the sounds of the bowel using advanced technology, correlation of sounds to physiology using manometry and/or auscultation, ... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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Vomiting is an involuntary forceful extrusion of stomach contents. It is a mediated by a complex reflex that is located in the vomiting center of the medulla oblongata. Reflex vomiting results when... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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Constipation is a common complaint, accounting for 3% of all pediatric office visits. Stool frequency can be variable in infants, who average 4 per day (SD 1.8) at 1 week, 2.2 per day (SD 1.6) at 1 month, and 1.8 per day (SD... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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Vomiting is the forceful expulsion of gastric contents through the mouth that involves an integrated and largely somatic motor response. It represents a protective reflex in the body's defense system. Vomiting may be an... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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Decreased bowel sounds can be as innocent as a hungry patient anticipating his or her next meal or as ominous as an impending abdominal catastrophe necessitating emergent laparotomy. However, the sensitivity and specificity of the... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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Normal bowel sounds (BS) are intermittent low-to-medium-pitched gurgles interspersed with occasional high-pitched, tinkling metallic sounds heard every 10–30 seconds. In acute intestinal... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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Projectile vomiting is the forceful expulsion of stomach contents classically associated with pyloric stenosis. Although pyloric stenosis is one cause, there are many other causes inside... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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... The causes of constipation can be recalled on a physiologic basis. Normal defecation requires feces that are of proper consistency, good muscular contraction of the walls of the large intestine, and unobstructed passage of the
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... These two should be considered together, because nausea is just a forme fruste of vomiting. This symptom lends itself well to anatomic analysis, particularly
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... Sometimes audible without a stethoscope, hyperactive bowel sounds reflect increased intestinal motility (peristalsis). They're commonly characterized as rapid, rushing, gurgling waves of sounds. (See Characteristics... Emergency interventions ... History and physical examination ... Medical causes ... Special considerations ... Pictures
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... Hypoactive bowel sounds, detected by auscultation, are diminished in regularity, tone, and loudness from normal bowel sounds. In themselves, hypoactive bowel sounds don't... History and physical examination ... Medical causes ... Other causes ... Special considerations
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... Constipation is defined as small, infrequent, or difficult bowel movements. Because normal bowel movements can vary in frequency and from individual to individual, constipation is relative... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pictures
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... With intestinal obstruction, peristalsis temporarily increases in strength and frequency as the intestine contracts to force its contents past the obstruction. As a result, visible peristaltic waves may roll across... History and physical examination ... Medical causes ... Special considerations ... Pediatric pointers ... Geriatric pointers
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... Vomiting is the forceful expulsion of gastric contents through the mouth. Characteristically preceded by nausea, vomiting results from a coordinated sequence of abdominal muscle contractions and reverse esophageal... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Pictures
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... Absent bowel sounds refers to an inability to hear any bowel sounds with a stethoscope in any quadrant after listening for at least 5 minutes. Bowel sounds cease when mechanical or... Emergency interventions ... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pictures
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... Behavioral/Psychiatric Factors
Low-residue diet
Chronic laxative and/or enema abuse
Immobility
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... 1. Feldman M, Scharschmidt BF, Sleisenger MH (eds): Sleisenger and Fordtran's Gastrointestinal and Liver Disease, 6/e. Philadelphia: WB Saunders, 1997.
2. Haubrich WS, Schaffner F,
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... Upper Gastrointestinal Bleeding
Inflammation
Esophageal ulcer
Gastric ulcer*
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... Oral or Oropharynx
Infections
Candida spp.
HSV
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... Central Nervous System Disorders
Increased intracranial pressure
Head trauma
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... Signs and Symptoms Depending on location of obstruction: nausea, vomiting, diarrhea, abdominal pain, drowsiness, thirst, rebound tenderness, abdominal distention,... Treatment (Tx) ... Pictures
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... The GI tract, also known as the alimentary canal, is a long, hollow, musculomembranous tube consisting of glands and accessory organs (salivary glands, liver, gallbladder,... Accurate assessment vital ... Visual assessment ... Auscultation, palpation, and percussion ... Diagnostic tests ... Intubation ... Pictures
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... Irritable bowel syndrome (IBS), also called spastic colon and spastic colitis, is a common condition marked by chronic or periodic diarrhea, alternating with... Causes and incidence ... Signs and symptoms ... Diagnosis ... Treatment ... Special considerations
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... Sometimes audible without a stethoscope, hyperactive bowel sounds reflect increased intestinal motility (peristalsis). They’re commonly characterized as rapid, rushing, gurgling waves of sounds. (See Characteristics of... Emergency interventions ... History and physical examination ... Medical causes ... Special considerations ... Pediatric pointers ... Patient counseling ... Pictures
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... Hypoactive bowel sounds, detected by auscultation, are diminished in regularity, tone, and loudness from normal bowel sounds. In themselves, hypoactive bowel sounds don’t herald an emergency; in fact, they’re considered... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers
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... Constipation is defined as small, infrequent, or difficult bowel movements. Because normal bowel movements can vary in frequency and from individual to individual, constipation must be determined in... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Patient counseling ... Pictures
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... With intestinal obstruction, peristalsis temporarily increases in strength and frequency as the intestine contracts to force its contents past the obstruction. As a result, visible peristaltic waves may roll... History and physical examination ... Medical causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Patient counseling
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Vomiting
(Professional Guide to Signs & Symptoms (Fifth Edition))
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... Vomiting is the forceful expulsion of gastric contents through the mouth. Characteristically preceded by nausea, vomiting results from a coordinated sequence of abdominal muscle contractions and reverse esophageal peristalsis. ... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Patient counseling ... Pictures
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... Absent bowel sounds refers to an inability to hear any bowel sounds through a stethoscope after listening for at least 5 minutes in each abdominal quadrant. Bowel sounds cease when mechanical or vascular obstruction or neurogenic inhibition... Emergency interventions ... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Pictures
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Constipation
(The 10-Minute Diagnosis Manual: Symptoms and Signs in the Time-Limited Encounter)
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... W. Robert Kiser
Approach Constipation, defined as the passage of two or fewer stools per week (1), is the most frequently reported gastrointestinal ... History ... Physical examination ... Diagnostic testing ... Diagnostic assessment
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... Mark B. Stephens
Gastrointestinal (GI) bleeding is responsible for 1% to 2% of all hospital admissions in the United States (1). Bleeding can be either acute or chronic. The source can be upper or lower, overt or... Approach ... History ... Physical examination ... Laboratory evaluation ... Diagnostic assessment ... Pictures
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Nausea and Vomiting
(The 10-Minute Diagnosis Manual: Symptoms and Signs in the Time-Limited Encounter)
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... Eric M. Walsh
Approach Nausea and vomiting are common presenting complaints in office practice. An effective diagnostic approach will consider causes both within the ... History. ... Physical examination. ... Testing. ... Diagnostic assessment
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... Differential Overview
❑ Lifestyle
❑ Drugs
❑ Depression
❑... Diagnostic Approach ... Clinical Findings
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... Differential Overview
Upper GI
❑ Peptic ulcer disease
❑ Gastritis
❑ Mallory-Weiss tear ... DIagnostic Approach ... Clinical Findings ... Pictures
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... Differential Overview
Presenting Symptom
❑ Gastroesophageal reflux
❑ Pregnancy
❑ Psychogenic ... Diagnostic Approach ... Clinical Findings
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... An intestinal obstruction is a partial or complete blockage of the lumen in the small or large bowel. A small-bowel obstruction is more common (90% of patients) and usually... Causes ... Signs and symptoms ... Diagnosis ... Treatment ... Special considerations ... Pictures
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... Also referred to as spastic colon or spastic colitis, irritable bowel syndrome is marked by chronic abdominal pain, alternating constipation and diarrhea, and abdominal distention. This... Causes ... Signs and symptoms ... Diagnosis ... Treatment ... Special considerations
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... Also known as lazy colon, colonic stasis, colonic inertia, and atonic constipation, chronic constipation may lead to fecal impaction if left untreated. It’s common in elderly and disabled people because... Causes ... Signs and symptoms ... Diagnosis ... Treatment ... Special considerations ... Pictures
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... Sometimes audible without a stethoscope, hyperactive bowel sounds reflect increased intestinal motility (peristalsis). They’re commonly characterized as rapid, rushing, gurgling waves of sound. (See Characteristics of... Assessment ... History ... Physical examination ... Pediatric pointers ... Geriatric pointers ... Medical causes ... Nursing considerations ... Patient teaching ... Pictures
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Vomiting
(Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series)
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... Vomiting is the forceful expulsion of gastric contents through the mouth. Characteristically preceded by nausea, vomiting results from a coordinated sequence of abdominal muscle... Assessment ... History ... Physical examination ... Pediatric pointers ... Geriatric pointers ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching ... Pictures
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Bowel sounds, absent
(Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series)
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... Absent bowel sounds refers to an inability to hear bowel sounds through a stethoscope after listening for at least 5 minutes in each abdominal quadrant. Bowel sounds cease when mechanical or vascular... Assessment ... History ... Physical examination ... Pediatric pointers ... Geriatric pointers ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching ... Pictures
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... Sometimes audible without a stethoscope, hyperactive bowel sounds reflect increased intestinal motility (peristalsis). They’re commonly characterized as rapid, rushing, gurgling waves of sounds. (See Characterizing... Emergency Actions ... History ... Physical assessment ... Medical causes ... Special considerations ... Pediatric pointers ... Patient counseling ... Pictures
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... Hypoactive bowel sounds, detected by auscultation, are diminished in regularity, tone, and loudness from normal bowel sounds. They may portend absent bowel sounds, which can indicate a life-threatening... History ... Physical assessment ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Patient counseling ... Pictures
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... Constipation is defined as small, infrequent, or difficult bowel movements. Because normal bowel movements can vary in frequency and from individual to individual,... History ... Physical assessment ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Patient counseling ... Pictures
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... With intestinal obstruction, peristalsis temporarily increases in strength and frequency as the intestine contracts to force its contents past the obstruction. As a result, visible peristaltic waves may roll across the... History ... Physical assessment ... Medical causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Patient counseling ... Pictures
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... Vomiting is the forceful expulsion of gastric contents through the mouth. Characteristically preceded by nausea, vomiting results from a coordinated sequence of abdominal muscle contractions and reverse esophageal... History ... Physical assessment ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Patient counseling ... Pictures
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... Absent bowel sounds, or silent abdomen, refers to an inability to hear any bowel sounds through a stethoscope after listening for at least 5 minutes in each abdominal quadrant. Bowel sounds cease when... Emergency Actions ... History ... Physical assessment ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Patient counseling ... Pictures
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Constipation
(The Diagnostic Approach to Symptoms and Signs in Pediatrics)
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... Constipationis difficult passage of hard stools. Clinical problem is not infrequent passageper se, but difficult and painful bowel movements. Common manifestations include crampyabdominal... Principal Causes of Constipation ... Clinical Features and Diagnosis ... Diagnostic Approach ... References
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... Can occuranywhere from nose and mouth to anus. Bleeding that occurs proximal to ligamentof Treitz is considered upper tract bleeding, whereas bleeding thatoccurs distal to this ligament is considered lower tract bleeding. ... Principal Causes of Gastrointestinal Bleeding ... Clinical Features and Diagnosis ... Diagnostic Approach ... References
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...Regurgitation is the nonforceful expulsionof contents from esophagus or stomach, whereas vomiting is the forcefulexpulsion of gastric contents through the mouth. The first partof this chapter is concerned with regurgitation and... Principal Causes of Regurgitation ... Clinical Features and Diagnosis: Regurgitation ... Diagnostic Approach: Regurgitation ... Principal Causes of Vomiting ... Clinical Features and Diagnosis: Vomiting ... Diagnostic Approach: Vomiting ... References
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... Sometimes audible without a stethoscope, hyperactive bowel sounds reflect increased intestinal motility (peristalsis). They're commonly characterized as rapid, rushing, gurgling waves of sounds. (See ... History and physical examination ... Medical causes ... Nursing considerations ... Patient teaching ... Pictures
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... Hypoactive bowel sounds, detected by auscultation, are diminished in regularity, tone, and loudness from normal bowel sounds. They don't herald an emergency; in fact, they're... History and physical examination ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching
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... Constipation is defined as small, infrequent, or difficult bowel movements. Because normal bowel movements can vary in frequency and from individual to individual, constipation is relative and must be determined in relation to... History and physical examination ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching ... Pictures
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... With intestinal obstruction, peristalsis temporarily increases in strength and frequency as the intestine contracts to force its contents past the obstruction. As a result, visible peristaltic waves may roll... History and physical examination ... Medical causes ... Nursing considerations ... Patient teaching
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... Vomiting is the forceful expulsion of gastric contents through the mouth. Characteristically preceded by nausea, vomiting results from a coordinated sequence of abdominal muscle contractions and reverse esophageal peristalsis. ... History and physical examination ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching ... Pictures
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... Absent bowel sounds refers to an inability to hear any bowel sounds with a stethoscope in any quadrant after listening for at least 5 minutes in each quadrant. Bowel sounds cease... History and physical examination ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching ... Pictures
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...
The causes of constipation can be recalled on a physiologic basis.
Normal defecation requires feces that are of proper consistency, good
muscular contraction of the walls of the large... Pictures
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...
These two should be considered together, because nausea is just a
forme fruste of vomiting. This symptom lends itself well to anatomic analysis,
particularly by the target method illustrated on... Pictures
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