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Constipation, Emergency Medicine

Julia H. Sone Reviewed 06/2017
 


Basics

Description

Rome Criteria for the diagnosis of constipation requires 2 or more of the following for at least 3 mo: 
  • Straining >25% of the time

  • Hard stools >25% of the time

  • Incomplete evacuati...

Diagnosis

Signs and Symptoms

  • Constipation is a symptom, not a disease.

  • Passage of hard stool

  • Straining/difficulty passing stool

  • Infrequent bowel movements

  • Abdominal distention/bloating

  • Firm/hard stool on di...

Treatment

Pre-Hospital

Establish IV access for patients with significant abdominal pain. 

Initial Stabilization/Therapy

IV fluids for dehydrated/hypotensive patients 

Ed Treatment/Procedures

  • Clean out colo...

Follow-Up

Disposition

Admission Criteria

  • Patients with severe abdominal pain, nausea, and emesis

  • Neurologically impaired, elderly, morbidly obese who cannot be cleaned out in the ED or home

  • Bowel obstruct...

Pearls and Pitfalls

  • Advise patients regarding appropriate dietary and lifestyle changes to decrease incidence of constipation.

  • Perform thorough history and physical exam to exclude significant medical ...

Additional Reading

  • Doody  DP, Flores  A, Rodriguez  LA. Evaluation and management of intractable constipation in children. Semin Colon Rectal Surg.  2006;17(1):29–37.

  • Ford  AC, Talley  NJ. Laxativ...

Codes

ICD9

  • 564.00 Constipation, unspecified

  • 564.09 Other constipation

  • 564.8 Other specified functional disorders of intestine

  • 564.01 Slow transit constipation

  • 751.3 Hirschsprung's disease and other congeni...

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