Constipation :: PLAB 2 Symptomatic Differential Stations

• Constipation from codeine:

  • Other presenting symptoms- 

    • History of codeine intake for pain (usually after surgery)

    • Rule out intestinal obstruction:

      • Passing gas

      • Abdominal pain/ vomiting

  • Past history and PMAFTOSA- 

    • Physical activity

    • Other medications

    • Diet history

  • Social-

    • 
      

  • Exam and Invs

    • GPE, vitals

    • Abdominal exam

    • PR exam

  • Referral 

    • None

  • Treatment 

    • Stop codeine, change to other painkillers

    • Laxatives

    • Phosphate enema

    • High fibre diet

    • Also don’t forget about whatever surgery they went through and manage that.

  • Warning signs:

    • Vomiting

    • Not passing flatus