ST Thomas University advanced pathophysiology Therapeutic Benefits and Dietary Restrictions of Fiber Intake:

Discussion #1 

Virginia Beata 

In your own words define constipation and name the risk factors that might lead to developing constipation. List recommendations you would give to a patient who is suffering from constipation. You might use a previous experience you might have.

Constipation is a condition composed of difficult and infrequent bowel movements. Risk factors include a low-fiber diet, inadequate fluid intake, a

sedentary lifestyle, increased stress, and a patient’s delay in the urge to defecate (Dlugasch & Story, 2024). Recommendations to alleviate

constipation includes taking stool softeners, using fiber supplements such as psyllium husk or Metamucil, and increasing fluid intake. Preventing

constipation includes increasing dietary fiber through foods like whole grains, fruits, and vegetables and physical activity to aid in the movement of

stool. Avoid laxative use because laxatives smooth intestinal rugae, making it more difficult for the intestine to perform its normal function

(Dlugasch & Story, 2024). Reducing stress will aid in normal bowel function because stress stimulates the sympathetic nervous system which slows

gastrointestinal motility (Dlugasch & Story, 2024).

Based on the clinical manifestations on R.H. case study, name and explain the signs and symptoms presented that are compatible with the constipation diagnosis. Complement your list with signs and symptoms not present in the case study.

Clinical manifestations that R.H. is experiencing include feeling bloated, straining during defecation, and infrequent bowel movements with hard

stools. Other symptoms of constipation include pain during defecation, rectal bleeding, abdominal pain, cramping, the sensation of feeling that one

hasn’t completely emptied their bowels after a movement, and fewer than three bowel movements a week (Diaz et al., 2023).

Sometimes as an associated diagnosis and a complication, patients with constipation could have anemia. Would you consider that possibility based on the information provided in the case study?

Anemia could potentially be a problem for R.H., especially since she frequently uses naproxen and complains of heartburn which could indicate

inflammation and irritation that can lead to bleeding, so a complete blood count panel is recommended to evaluate for anemia. R.H. needs to be

questioned further about the characteristics of her stool. If she sees any bright red blood in her stool, that could allude to rectal bleeding or dark

tarry stools could indicate internal bleeding.

In which race and ethnic groups is DM more prevalent? Based on C.B. clinical manifestations, please compile the signs and symptoms that she is exhibiting that are compatible with the Diabetes Mellitus Type 2 diagnosis.

Diabetes mellitus is more prevalent in Native Americans, Asian Americans, African Americans, and Hispanics (Galicia-Garcia et al., 2020). Compatible

signs and symptoms of diabetes mellitus that C.B. is exhibiting include high blood sugar, especially a fasting blood sugar of 141, increased thirst, and

frequent urination.  Polyuria occurs due to an increased need to excrete glucose to lower glucose serum levels (Dlugasch & Story, 2024). This leads

to polydipsia because the increased urine output leads to dehydration resulting in increased thirst. A fasting blood sugar greater than 126mg/dL

indicates diabetes (Dlugasch & Story, 2024). Weakness and numbness in the foot suggest neuropathy, a condition seen with diabetes mellitus.

Other manifestations of diabetes mellitus include glucosuria, fatigue, blurred vision, and polyphagia (Dlugasch & Story, 2024).

If C.B. develops bacterial pneumonia on her right lower lobe, how would you expect her glycemia values to be? Explain and support your answer.

If C.B. developed bacterial pneumonia, her glycemia values would be elevated. Infection and illness cause stress on the body which leads to

increased blood sugar levels. High glucose levels impair the phagocytic activity of macrophages which can explain the increased incidence of chronic

infection in type two diabetes mellitus (Galicia-Garcia et al., 2020).

What would be the best initial therapy non-pharmacologic and pharmacologic to be recommended to C.B?

Non-pharmacologic measures recommended for C.B. include eating a balanced diet of whole foods, avoiding processed foods, and increasing

physical exercise. These measures will help with weight management and improve insulin sensitivity. Pharmacological interventions include oral

diabetic medications such as metformin and if C.B.’s blood sugar is not well controlled with oral medications, insulin injections may be required (Quattrocchi et al., 2020).

Discussion #2

Melissa Cuellar 

Gastrointestinal Function

Constipation

Constipation is a typical gastrointestinal disorder that manifests itself in irregular, unpleasant, or infrequent bowel motions that are often accompanied by hard stools. The symptoms of bloating and constipation that R.H., a 74-year-old lady, has been suffering with for the last month extend beyond the occasional pain. Physiological and behavioral variables both have a role in the onset and progression of constipation (Diaz et al., 2023).

The onset of constipation is associated with many risk factors. The fact that R.H. is 74 years old is a major consideration in her case. Constipation is more common and stool transit times are slower as people age due to a natural decrease in intestinal function (Ram Bhandari & Shahi, 2022). In cases like R.H.’s, where arthritis prevents her from going for regular walks, a lack of physical exercise might lead to constipation. Furthermore, inadequate fluid consumption is widespread among the elderly, and dehydration is a prevalent risk factor.

Recommendations

Changing one’s way of living is usually the best course of action for a patient with constipation. Eating more fiber-rich foods, such as fruits, vegetables, and whole grains, may help regulate bowel motions. Patients need to drink enough water throughout the day to stay hydrated. Consistent physical activity, even if it’s only light workouts, may help improve gastrointestinal motility. To manage constipation, it is vital to establish a regular bathroom routine, ensure that you sit comfortably on the toilet, and treat any underlying medical issues.

In retrospect, I remember briefly suffering from constipation because of dietary changes and decreased physical activity while on vacation. My symptoms drastically improved once I started following the advice above, which included drinking more water and eating more fiber.

Signs and Symptoms

Upon reviewing R.H.’s case, it seems that constipation is the most appropriate diagnosis. Classic constipation symptoms include her complaints of bloating, straining, infrequent bowel motions (once a week), and firm stools. It is worrisome when symptoms persist for such a long time. While the case study may have highlighted certain symptoms, it is essential to consider any additional ones (S. Somwaru, 2021). Constipation symptoms include but are not limited to, stomach discomfort, a sensation of incomplete evacuation, and rectal bleeding.

Heartburn is another major symptom of R.H.; it happens three to four times a week, often just before bed. This may indicate the presence of an associated medical condition, such as GERD, or a possible problem. The fact that she found relief and improvement in her symptoms after taking aluminium hydroxide pills lends credence to this theory. As a defense strategy against acid reflux, many people prefer to sleep with their heads propped up on pillows.

Anemia and Constipation

It is reasonable to assume that R.H. may have suffered from anemia due to her constipation. The case report does not include her hemoglobin levels or any other indications of anemia, but chronic constipation may cause issues such as rectal hemorrhage, which can lead to iron-deficiency anemia (S. Somwaru, 2021). In this case, it would be crucial to monitor blood levels and do further examinations to confirm or rule out anemia as a potential consequence.

Age, lifestyle, and physiological variables all play a role in the complex disease of constipation. The example of R.H. shows how important it is to have a complete evaluation, considering not only the main symptoms but also any complications or associated illnesses, including GERD and anemia. For successful treatment, it is necessary to address these factors with suitable suggestions and medical or lifestyle interventions.

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