make the patient at risk for a volvulus. Ask the patient to describe any symptoms, which may include abdominal distension, thirst, and abdominal pain. Patients may also report anorexia and food intolerance, with vomiting after eating. Late signs include colicky abdominal pain of sudden onset and vomiting with sediment and a fecal odor. The patient may also describe chronic constipation with no passage of gas or feces, or when a stool is passed, there may be blood in it.

PHYSICAL EXAMINATION. The patient usually appears in acute distress from abdominal pain and pressure. The patient's abdomen appears distended, and the patient may show signs of dehydration such as poor skin turgor and dry mucous membranes. Measure the abdominal girth to identify the amount of distension. When you auscultate the abdomen, you may hear no bowel sounds at all, indicating a paralytic ileus, or you may hear high-pitched peristaltic rushes with high metallic tinkling sounds, indicating intestinal obstruction. You may be able to palpate an abdominal mass, although the patient experiences pain and guarding on palpation.

PSYCHOSOCIAL. The patient may have lived with constipation for a long time and may be embarrassed to discuss the issue of bowel movements or may hold certain beliefs about the frequency and consistency of bowel movements. Assess the patient's self-image and the patient's ability to cope with possible body disfigurement from surgical correction. If the patient is an adult, determine the patient's ability to provide self-care.

Diagnostic Highlights


Normal Result

Abnormality with Condition


Abdominal x-rays

Normal abdominal structures

Distended loops of bowel; may be normal x-ray

Identifies blockage of lumen of bowel with distal passage of fluid and air (partial) or complete obstruction

Barium enema

Normal abdominal structures

Partial or complete blockage of lumen of bowel

Identifies site of volvulus

Other Tests: Complete blood count, colonoscopy, sigmoidoscopy, abdominal computed tomography (CT) scan, stool heme test.

Constipation Prescription

Constipation Prescription

Did you ever think feeling angry and irritable could be a symptom of constipation? A horrible fullness and pressing sharp pains against the bladders can’t help but affect your mood. Sometimes you just want everyone to leave you alone and sleep to escape the pain. It is virtually impossible to be constipated and keep a sunny disposition. Follow the steps in this guide to alleviate constipation and lead a happier healthy life.

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