Example+of+treatment+flowchart

//Constipation in Cancer // by Scott Moses, MD

 * 1) ==== See Also ====
 * 2) [|Bowel Regimen in Chronic Narcotic Use]
 * 3) ==== Causes ====
 * 4) Attempt to identify cause
 * 5) Do not assume [|Narcotic] s are always the cause
 * 6) ==== Differential Diagnosis ====
 * 7) [|Bowel Obstruction in Terminally Ill Patient]
 * 8) ==== Management: Address each of four factors ====
 * 9) See [|Bowel Regimen in Chronic Narcotic Use]
 * 10) Low intestinal solids
 * 11) Due to decreased [|Dietary Fiber]
 * 12) Manage with [|Psyllium]
 * 13) Avoid in dehydration due to stool impaction risk
 * 14) Low stool water content
 * 15) Causes
 * 16) Dehydration
 * 17) Slow stool transit time
 * 18) Decreased intestinal water secretion
 * 19) Management
 * 20) [|Lactulose] 30 ml PO q4-6 hours
 * 21) [|Sorbitol] 30 ml PO q2-4 hours until stool
 * 22) [|Glycerin] suppositories
 * 23) Low gastrointestinal motility
 * 24) Causes
 * 25) Non-ambulatory or bed-ridden patient
 * 26) Neurodegenerative disease
 * 27) Medications
 * 28) Morphine and other [|Narcotic] s
 * 29) [|Tricyclic Antidepressant] s
 * 30) Scopolamine
 * 31) [|Diphenhydramine] ( [|Benadryl] )
 * 32) Vincristine
 * 33) [|Calcium Channel Blocker] s
 * 34) [|Iron Supplementation]
 * 35) [|Calcium Supplementation]
 * 36) Aluminum salts
 * 37) Management
 * 38) [|Senna]
 * 39) [|Bisacodyl]
 * 40) Prune juice
 * 41) [|Casanthranol]
 * 42) Decreased gastrointestinal lubrication
 * 43) Due to dehydration
 * 44) Management
 * 45) [|Mineral Oil] enemas
 * 46) [|Glycerin] suppositories
 * 47) Dioctyl sodium sulfosuccinate
 * 48) ==== Prevention ====
 * 49) See [|Bowel Regimen in Chronic Narcotic Use]
 * 50) Prevention is much easier than treatment
 * 51) Administer prophylactic medications with [|Narcotic] s
 * 52) Gastrointestinal motility [|Stimulant Laxative] and
 * 53) [|Stool Softener]
 * 54) Example Agent: Pericolace
 * 55) ==== References ====
 * 56) Hallenbeck (2000) End-of-life Physician Resources #15
 * 57) []
 * 58) [|Ross (2001) Am Fam Physician 64(6):1019-26]