Constipation

Answer Explanation:

The correct answer is Parkinson’s disease. Here’s why:

• Parkinson’s disease is a neurodegenerative disorder that affects predominately dopamine-producing neurons in a specific area of the brain called substantia nigra.
• One of the non-motor symptoms of Parkinson’s disease is constipation. This is due to the slow movement of the digestive tract caused by the disease.
• Constipation can occur in the early stages of the disease, even before the motor symptoms are noticeable.

The other options are incorrect for the following reasons:

• Colovesical fistula: This is an abnormal connection between the colon and the bladder. It can cause symptoms like frequent urinary tract infections, air or stool passing during urination, but not constipation.
• Non-steroidal anti-inflammatory drugs (NSAIDs): These medications can cause gastrointestinal issues, but they are more likely to cause dyspepsia, gastric ulcers, or bleeding rather than constipation.
• Carcinoid syndrome: This condition is associated with diarrhea, not constipation.
• Syndrome of inappropriate antidiuretic hormone secretion (SIADH): This condition leads to hyponatremia and its associated symptoms. It does not cause constipation.

Overview of Parkinson’s Disease:

• Parkinson’s disease is a progressive nervous system disorder that affects movement.
• Symptoms start gradually, sometimes starting with a barely noticeable tremor in just one hand. Tremors are common, but the disorder also commonly causes stiffness or slowing of movement.
• In the early stages of Parkinson’s disease, your face may show little or no expression. Your arms may not swing when you walk. Your speech may become soft or slurred.
• Parkinson’s disease symptoms worsen as your condition progresses over time.
• Non-motor symptoms may also occur, and can include cognitive changes, mood disorders, sleep difficulties, constipation, and others.

Answer Explanation:

• Myxoedema, Hirschsprung’s disease, iron tablets, and patient-controlled analgesia are all known to cause constipation.
• Myxoedema is a condition resulting from severe hypothyroidism which slows down the body’s metabolic processes including bowel movements, leading to constipation.
• Hirschsprung’s disease is a congenital condition where nerve cells are missing from a part of the bowel, causing difficulty in passing stool.
• Iron tablets are a common cause of constipation as they can make the stool harder to pass.
• Patient-controlled analgesia, particularly those containing opioids, can slow down the digestive system and cause constipation.
• Magnesium-containing antacids, on the other hand, are not known to cause constipation. In fact, they can often have a laxative effect and are sometimes used to treat constipation.

Overview of Constipation:

• Constipation is a common condition that affects people of all ages. It can mean that you’re not passing stools regularly or you’re unable to completely empty your bowel.
• Constipation can also cause your stools to be hard and lumpy, as well as unusually large or small.
• The severity of constipation varies from person to person. Many people only experience constipation for a short period of time, but for others, constipation can be a chronic (long-term) condition that causes significant pain and discomfort and affects quality of life.
• Common causes of constipation include lack of fiber in the diet, lack of physical activity, certain medications, and aging. However, it can also be caused by more serious health conditions like hypothyroidism and neurological disorders.

Answer Explanation:

• The correct answer is Anal fissure. This is because anal fissures can cause pain during bowel movements, which may lead to constipation due to the avoidance of passing stools.
• Coeliac disease, hyperthyroidism, anaemia, and giardiasis are not typically associated with constipation. In fact, coeliac disease and hyperthyroidism are more commonly associated with diarrhoea. Anaemia does not directly affect bowel movements, and giardiasis usually causes diarrhoea, not constipation.

Overview of Anal Fissures:

• An anal fissure is a small tear in the thin, moist tissue (mucosa) that lines the anus. This may occur when passing large or hard stools.
• Common symptoms include pain during and after bowel movements, bright red blood on the stool or toilet paper after a bowel movement, a visible crack in the skin around the anus, and in some cases, a small lump or skin tag on the skin near the fissure.
• Anal fissures are most common in young infants but can affect people of all ages. They are often caused by constipation, straining during bowel movements, and childbirth.
• Most anal fissures get better with simple treatments, such as increased fibre intake or sitz baths. Some people with persistent or recurring fissures may need medication or surgery.

Answer Explanation:

• Ispaghula husk is the correct answer because it is a bulk-forming laxative that is safe to use routinely for simple constipation. It works by increasing the bulk of your stools, which encourages your bowels to move the stools through your digestive system, which in turn helps to relieve constipation.
• Co-danthramer is a strong laxative and painkiller used in palliative care. It is not typically used for simple constipation due to its strength and potential side effects.
• Buscopan is an antispasmodic, not a laxative. It is used to relieve abdominal cramps, which can be a symptom of conditions like Irritable Bowel Syndrome (IBS), but it does not treat constipation.
• Loperamide is an anti-diarrheal medication, not a laxative. It works by slowing down the movement of the gut. This increases the time between bowel movements and makes the stools less watery.
• Sodium picosulfate is a stimulant laxative that encourages the muscles in your bowel to move stools through your body. It is typically used for short-term relief of constipation, not for routine use.

Overview of Simple Constipation:

• Simple constipation, also known as functional constipation, is a common condition where a person has infrequent bowel movements or hard, dry stools.
• It is often caused by a lack of fibre in the diet, not drinking enough fluids, lack of physical activity, stress, or ignoring the urge to go to the toilet.
• Simple constipation can usually be treated by making dietary and lifestyle changes, such as increasing fibre intake, drinking plenty of fluids, getting regular exercise, and not ignoring the urge to go to the toilet.
• If these changes do not help, a bulk-forming laxative like Ispaghula husk may be recommended for routine use. Other types of laxatives, such as stimulant laxatives, are usually only recommended for short-term use.