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Definition of constipation and diarrhoea Definition of constipation and diarrhoea
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Prevalence of constipation and diarrhoea Prevalence of constipation and diarrhoea
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Normal intestinal physiology Normal intestinal physiology
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Intestinal motility Intestinal motility
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Intestinal fluid handling Intestinal fluid handling
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Causes of constipation Causes of constipation
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Diagnosis Diagnosis
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Assessment Assessment
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Impaction, presenting as diarrhoea, often with incontinence Impaction, presenting as diarrhoea, often with incontinence
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Intestinal obstruction by tumour or adhesions Intestinal obstruction by tumour or adhesions
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Nausea Nausea
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Abdominal pain Abdominal pain
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Urinary incontinence Urinary incontinence
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Investigations Investigations
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Measurement tools Measurement tools
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Treatment Treatment
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Stimulant laxatives Stimulant laxatives
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Softening laxatives Softening laxatives
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Newer developments Newer developments
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Diarrhoea Diarrhoea
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Prevalence of diarrhoea Prevalence of diarrhoea
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Clinical manifestations and diagnostic considerations Clinical manifestations and diagnostic considerations
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Assessment Assessment
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Examination and investigations Examination and investigations
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Management approaches Management approaches
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Supportive treatment Supportive treatment
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Specific treatment Specific treatment
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General treatment General treatment
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New developments New developments
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References References
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Online references Online references
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10.3 Constipation and diarrhoea
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Published:March 2015
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Abstract
Constipation is far more common in palliative care than diarrhoea and results not just from the use of opioids but also from the multifactorial effects of debility secondary to disease. Most palliative care patients will require regular administration of an oral laxative in a dose titrated against response, with the aim of avoiding the use of suppositories or enemas if possible as these are less liked. The lack of clear differences in laxative efficacy means that cost and patient choice are key factors in guiding treatment. Diarrhoea in palliative care most often results from excess laxative or from common infections that can be simply managed. Bowel shortening or diversion causes more resistant diarrhoea. Cytotoxic chemotherapy can lead to diarrhoea either as an adverse effect of treatment or from potentially life-threatening neutropenic colitis.
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