Physical Therapy Management of Constipation
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Questions and Answers

What primary method is utilized in biofeedback therapy to assist with constipation management?

  • Increasing dietary fiber intake
  • Inserting a probe into the anal sphincter (correct)
  • Medication to stimulate bowel movement
  • Hydration through intravenous fluids
  • What is one key component of biofeedback therapy sessions for constipation management?

  • Providing a laxative
  • Monitoring pulse rate
  • Encouraging increased physical activity
  • Teaching relaxation techniques (correct)
  • How does pelvic floor muscle strength effectively impact bodily functions?

  • It solely increases bladder capacity.
  • It reduces abdominal pressure.
  • It eliminates all symptoms of constipation.
  • It enhances bowel and bladder control. (correct)
  • What is the recommended daily fiber intake to support bowel health?

    <p>25-35 grams</p> Signup and view all the answers

    Which practice is NOT recommended for improving posture while using the toilet?

    <p>Tilting the pelvis backward</p> Signup and view all the answers

    What is the recommended number of glasses of water one should consume daily to aid in preventing constipation?

    <p>6-8 glasses</p> Signup and view all the answers

    What role does diaphragmatic breathing play during biofeedback therapy for constipation?

    <p>It helps to push and bear down effectively.</p> Signup and view all the answers

    Which positioning technique is recommended when using the toilet to facilitate better stool passage?

    <p>Knees higher than hips</p> Signup and view all the answers

    Which type of exercise is suggested to help improve constipation by enhancing gastrointestinal transit time?

    <p>Aerobic exercises like walking</p> Signup and view all the answers

    Biofeedback therapy for constipation primarily aims to improve coordination of which muscle groups?

    <p>Rectal, puborectalis, and anal sphincter muscles</p> Signup and view all the answers

    What aspect of the treatment for constipation is often considered good news?

    <p>It can effectively avoid the use of medications.</p> Signup and view all the answers

    What role does biofeedback therapy play in managing constipation?

    <p>It helps to improve the function of pelvic floor muscles.</p> Signup and view all the answers

    What is typically measured by the sticky pads placed on the abdomen during biofeedback therapy?

    <p>Movement of anal sphincter and abdominal wall</p> Signup and view all the answers

    What dietary recommendation is commonly made to alleviate constipation?

    <p>Eat more high-fiber foods</p> Signup and view all the answers

    How does fluid intake correlate with constipation management?

    <p>Fluid intake helps to soften stools</p> Signup and view all the answers

    Which toilet positioning is recommended to help facilitate bowel movements?

    <p>Squatting with feet elevated on a stool</p> Signup and view all the answers

    Which type of exercise is commonly advised for individuals suffering from constipation?

    <p>Gentle aerobic exercises like walking</p> Signup and view all the answers

    When might biofeedback therapy be particularly beneficial in the management of constipation?

    <p>For individuals with psychogenic constipation</p> Signup and view all the answers

    What is a potential consequence of ignoring constipation symptoms over time?

    <p>Development of diverticulitis</p> Signup and view all the answers

    What psychological condition may exacerbate constipation symptoms?

    <p>Depression</p> Signup and view all the answers

    Which of the following is commonly NOT a cause of constipation?

    <p>Increased dietary fiber</p> Signup and view all the answers

    What is a defining characteristic of outlet constipation?

    <p>Muscle dysfunction at the anal sphincter</p> Signup and view all the answers

    Which condition is NOT typically associated with the symptoms of constipation?

    <p>Hyperactivity disorder</p> Signup and view all the answers

    What is a possible consequence of chronic straining from constipation on the pelvic floor muscles?

    <p>Weakening of the pelvic floor muscles</p> Signup and view all the answers

    How does overfull rectum due to constipation affect the bladder?

    <p>It may lead to the feeling of needing to urinate urgently</p> Signup and view all the answers

    Which method can assist bowel function as a management of constipation?

    <p>Abdominal massage</p> Signup and view all the answers

    What is a characteristic of fecal incontinence related to constipation?

    <p>It happens when stool leaks around constipated stool</p> Signup and view all the answers

    What technique is recommended for abdominal massage aimed at managing constipation?

    <p>Using lotion in effleurage or kneading</p> Signup and view all the answers

    For which condition should hot rolls not be applied?

    <p>During pregnancy</p> Signup and view all the answers

    What is the expected outcome from daily abdominal massage over 4 to 6 weeks?

    <p>Return to normal bowel function</p> Signup and view all the answers

    How does abdominal distension relate to constipation management?

    <p>It can decrease with effective abdominal massage</p> Signup and view all the answers

    Which statement about bladder dysfunction and constipation is incorrect?

    <p>Constipation does not affect bladder capacity</p> Signup and view all the answers

    What role do hot rolls play in managing constipation?

    <p>They help to stimulate normal peristaltic movement</p> Signup and view all the answers

    Study Notes

    Physical Therapy Assessment and Management of Constipation

    • Constipation is an acute or chronic condition characterized by infrequent bowel movements or hard, dry stools that are difficult to pass.
    • Adults who haven't had a bowel movement in three days, or children in four days, are considered constipated.
    • Other criteria for constipation include: at least 25% of bowel movements associated with straining, lumpy or hard stools, incomplete bowel evacuation, anorectal obstruction, and less than 3 bowel movements per week.

    Causes of Constipation

    • Bowel obstruction
    • Cancer
    • Dehydration
    • Hospital admission
    • Endocrine disorders (hyperparathyroidism, hypothyroidism, chronic renal disease)
    • Neuromuscular disorders (Parkinson's disease, MS)
    • Electrolyte imbalances (hypercalcemia, hypokalemia, hypermagnesemia)
    • Pregnancy
    • Depression
    • Reduced mobility and balance problems
    • Medications (including opioids)

    Symptoms and Consequences of Constipation

    • Nausea and/or vomiting
    • Abdominal and rectal pain
    • Flatulence
    • Loss of appetite
    • Fatigue
    • Depression
    • Nausea and reduced appetite may lead to weight loss
    • Behavioral disturbances in dementia may result in increased use of psychotropic medications.

    Quality of Life

    • A systematic review by Belsey et al (2010) shows that constipation negatively impacts quality of life in adults.
    • The study notes the impact on various aspects of life.

    Types of Constipation

    • General constipation: Problems with peristalsis (muscle contractions) in the large intestine slow or stop waste movement.

      • Factors include limited fluid and fiber intake, diet imbalances (too much sugar and animal fat), lifestyle changes (prolonged sitting, pregnancy, travel), certain medications, and a sluggish colon.
    • Outlet constipation: Stool is stuck in the rectum due to dysfunction of the pelvic floor muscles.

      • Tight pelvic floor muscles prevent stool from passing.
      • Can cause straining, leading to further muscle tightening.

    Physical Therapy Management for Constipation

    • Dietary Management: Aim for 25-35 grams of fiber daily. Choose fresh fruits, vegetables, and whole grains over processed foods. Increase your fluid intake to 6-8 glasses of water daily.

    • Toilet Positioning: Position knees higher than hips on the toilet seat. Use a footstool if needed. Lean forward, supporting elbows on knees. Expand your abdomen as you exhale, gently pressing stool out.

    • Exercise: Regular exercise, like walking, lower trunk rotation, stationary bicycling, and pelvic floor exercises, helps speed up transit time through the digestive tract.

    • Biofeedback Therapy: A physical therapist inserts a probe into the anal sphincter and places pads on the abdomen to detect muscle movement. Visual feedback helps patients learn how to coordinate bowel movements effectively.

    • Pelvic Floor Strengthening: Strong pelvic floor muscles are crucial for bladder and bowel control. Constipation straining may lead to muscle weakening, impacting bladder function and causing accidental leaks.

    • Abdominal Massage: Gentle massage technique applied to the abdomen along the colon's path. This helps stimulate peristalsis to release stool.

    • Hot Rolls: Use hot rolls on the abdomen following the direction of the colon, to stimulate peristalsis and relax spasming muscles.

    Additional Information

    • Constipation can worsen bladder function due to the rectum's close proximity to the bladder. Overfull rectum can press on bladder, reducing its capacity.
    • Constipation can lead to fecal incontinence due to weakened pelvic floor muscles. The stool may leak out.

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    Description

    Explore the assessment and management strategies for constipation as it pertains to physical therapy. Understand the symptoms, causes, and consequences of this common condition, and learn how to effectively address it in various patient populations.

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