Abstract This chapter examines the risk factors for constipation in the terminally ill patient, as well as explores the underlying pathophysiology of constipation in the setting of advanced illness. Normal bowel function requires coordination of gut motility with molecular transport across the bowel wall and reflexes of defecation. Disruption in any of these areas can affect normal bowel function. Unfortunately, in the setting of advanced illness, these factors are often disrupted. Patients nearing end of life often require medications to manage common symptoms related to terminal illness which often affect normal bowel function, adding another layer to consider when dealing with the patient’s constipation. Careful assessment, including history and physical examination, will be reviewed as they are needed to identify the best course of management. In certain situations, investigations and imaging may be required in order to better identify the cause. Many terminally ill patients are on opioids near end of life which are a class of medications notorious for causing constipation. This chapter will review the current evidence and management options for opioid-induced constipation, including a newer class of medications—the peripherally acting mu opioid receptor antagonists (PAMORAs).

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Constipation

Arnold Wald · Encyclopedia of Gastroenterology · 2004

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CONSTIPATION

Harold Ellis · French's Index of Differential Diagnosis · 1979

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Constipation.

PubMed · 1890

Cited by 0Open access

Constipation

Jose M. Garza, Ajay Kaul · 2014

Constipation has a significant impact on a child’s quality of life and on health care costs. The estimated medical care cost of a child with constipation per year is three times that of children without constipation. Children with constipation present with infrequent and/or painful passage of hard stools with or without fecal incontinence. The pathophysiology of constipation is multi-factorial; the two major categories are functional and organic. Functional constipation can result from a delay in colonic transit, abnormal sensation, or disordered anorectal function. The most common etiology in children is stool withholding that is triggered by an unpleasant experience having a bowel movement, leading to a vicious cycle of worsening rectal pain and constipation. A contrast enema is useful to identify anatomic abnormalities and to evaluate the rectosigmoid caliber in patients with chronic constipation with fecal incontinence refractive to medical management. Little data exist regarding safety profile of laxatives in short- and long-term treatment of constipation.

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[Constipation].

J Arnal · PubMed · 1966

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Constipation

National Diabetes Information Clearinghouse (NDIC) · Definitions · 2020

A condition in which the stool becomes hard and dry.A person who is constipated usually has fewer than three bowel movements in a week.Bowel movements may be painful.

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Constipation

Philip W. Brown · Medical Clinics of North America · 1949

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Constipation.

PubMed · 1876

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