Constipation

Acute Constipation

• Intestinal obstruction
  • Valvulus-Abnormal twisting of the intestine causing obstruction
  • Intussusception- Infolding of one part of the intestine into another
  • Incarcerated Hernia
• Acute abdomen
  • Appendicitis
  • Salpingitis- Inflammation of Fallopian tubes
    
  • Perforation of gut
  • Colics or pain abdomen

Chronic Constipation

Constipation that is slow o develop and is present for long time

• Faulty habits
  • Laxative abuse
  • Prolonged travel
  • Insufficient dietary roughage
• Painful anal conditions
  • Piles
  • Fissures
• Organic obstruction
  • Carcinoma
  • Diverticulum
  • Strictures
• Adynamic bowel
  • Scleroderma
  • Myopathies
  • Myotonia
• Metabolic:
  • Hypothyroidism
  • Hypokalemia
  • Hypercalcemia
  • Porphyria
  • Lead poisoning
• Drugs
  • Atropine and related drugs
  • Opium group
  • Tricyclic antidepressants

Common Digestive Problems-Flatulence, Heart Burns, Eructations, Indigestion

Flatulence

• Gastric Causes:

Aerophagy

Neurosis

Hiatus hernia

Pyloric stenosis

Biliary dyspepsia

Following vagotomy

• Food intake
  • Cabbage
  • Cauliflower
  • Peas
  • Beans
• Intestinal
  • Steatorrhea
  • Intestinal obstruction
  • Malignancy, etc.
• Systemic diseases
  • Cardiac failure
  • Cirrhosis

Heart Burns

• Organic lesions
  • Reflux oesophagitis
  • Hiatus hernia
  • Peptic ulcer
• Functional
  • Faulty dietary habits
  • Addictions
• Psychogenic
  • Neurosis
  • Repressed emotion

Eructation

• Faulty dietary habits
  • Aerated water
  • Chewing gum
  • Mouth breathing
• Addiction

• • Smoking
  • Alcohol
  • Betel nut
  • Paan

• Gastrointestinal

• • Gastritis
  • Peptic ulcer
  • Hiatus hernia
  • Cholecystitis
  • Stones
  • Irritable bowel syndrome.

• Psychogenic
  • Anxiety
  • Depression

Indigestion

• Upper gastrointestinal tract
  • Alcohol
  • Heavy meals
  • Aerophagia
  • Hiatus hernia
  • Gastroesophageal reflux
  • Peptic ulcer disease
  • Ggastritis
  • Drugs
• Lower gastrointestinal tract
  • Parasites
  • Food intolerance
  • Irritable bowel syndrome
  • Increased intraluminal gas
• Hepatobiliary
  • Cholecystitis
  • Stones
  • Pancreatitis
  • Splenic flexure syndrome
• Systemic diseases
  • Uremia,
  • Cardiac failure
  • Tuberculosis
  • Malignancy.
• Functional

What Can Cause Diarrhea?

1. Osmotic Causes
   • Laxative abuse
   • Maldigestion of food
2. Infections
   • Typhoid
   • Cholera
   • Amebiasis
   • Giardiasis
   • Helminthiasis
3. Endocrine diseases
   • Thyrotoxicosis
   • Diabetes
   • Addison’s disease
4. Drugs
   • Thyroxine
   • Prostigmine
   • Ampicillin
   • Phenolphthalein
5. Anxiety:
   • Irritable bowel syndrome
6. Miscellaneous
   • Malignant carcinoid syndrome.

Common and Uncommon Causes of Vomiting

1. Abdominal
   • Gastritis ulcer
   • Peptic ulcer
   • Colics
   • Acute abdominal emergencies
   • Appendicitis
   • Cholecystitis
   • Peritonitis
   • Pancreatitis
   • Intestinal obstruction
2. Cardiac:
   • Myocardial infarction
   • Cardiac failure
3. Central
   • Raised intracranial tension
   • Meningitis
   • Meniere’s disease
   • Motion sickness
   • Radiation
4. Metabolic
   • • Diabetes
     • Alcohol Intake
     • Pregnancy
     • Hypercalcemia
     • Addison’s disease.
5. Toxic
   • Febrile illnesses
   • Viral hepatitis
   • Drugs
   • Corrosive poisons.
6. Functional

Possible Causes of Pain in the Loin

1. Renal:
   • Stone
   • Malignancy
   • Infections (pyelonephritis, perinephric abscess, etc.)
   • Polycystic kidney
   • Dietl’s crisis-A sudden attack of acute lumbar and abdominal pain accompanied by nausea and vomiting, caused by kinking of the ureter in persons with wandering kidney.
2. Extra-renal:
   • Acute pancreatitis
   • Cholecystitis
   • Appendicitis
   • Porphyria
   • Ruptured duodenal ulcer or spleen
   • Ectopic gestation

Pain Abdomen-Possible Causes

1. Acid peptic disease
2. Peritonitis and Paralytic ileus
3. Mechanical obstruction of hollow viscus
4. Colics: Intestinal, renal, biliary, etc.
5. Vascular disturbances producing ischemia: Thrombo-embolism, sickle cell crisis rupture of aneurysm, etc.
6. Abdominal wall: Fatty hernia through linea alba, trauma or infection of the muscle etc.
7. Referred pain: Pneumonia, pleurisy, ischemic heart disease, panniculitis, torsion of the testes or ovary.
8. Metabolic: Diabetes, uremia, porphyria, lead poisoning
9. Neurogenic: Herpes zoster, tabes dorsalis, etc.
10. Functional

Causes of Blood in Urine or Hematuria

Blood in urine is called hematuria in medical language. Hematuria can be due to local causes in genito urinary system or due to systemic (Involving body in general) diseases.

Blood in urine could be due to many diseases. Here is the list

• Renal:
  • Glomerulonephritis
  • Renal infarction
  • Stones
  • Tumors
  • Tuberculosis
  • Interstitial nephritis
  • Papillary necrosis
  • Polycystic kidneys
• Ureteric:
  • Trauma
  • Tuberculosis
  • Stones
  • Neoplasms
• Bladder
  • Trauma,
  • Tuberculosis
  • Stones
  • Neoplasms
  • Cystitis
  • Following cyclophosphamide therapy

• Urethral

• • Trauma
  • Stones
  • Foreign body
  • Urethritis

• Prostatic
  • Prostitis
  • Neoplasms.
• Systemic disease
  • Diabetes
  • Amyloidosis
  • Collagen disease
  • DIC

Causes of Increased Volume of Urine or Polyuria

Passage of large volumes of urine is known as polyuria. It could be caused by following

• Excessive drinking
• Diuretic therapy
• Cold weather
• Stress
• Diabetes insipidus
• Compulsive water drinking
• Diabetes mellitus
• Chronic renal failure
• Recovery from acute tubular necrosis
• Prostate Hypertrophy
• Prostate Cancer

Common Urinary Problems and Their Causes

Frequency of Micturition and Nocturia

1. Bladder: Cystitis, small contracted bladder, tumors, vesicular calculus, cystocele.
2. Bladder neck: Incomplete evacuation due to enlarged prostrate or stricture of urethra, incompetent internal urethral sphincter, ectopic ureter.
3. Urethra: Urethritis, neoplasms, balanitis, stricture of urethra, pinhole meatus, phimosis.
4. Miscellaneous: Polyuria, psychogenic, pregnancy, pressure from surrounding structures.

Hesitancy and Precipitancy of Urine

1. Cerebral: Cerebrovascular accidents, cerebral tumors, head injuries, etc.
2. Urinary tract disease: Enlarged prostate, bladder neck obstruction.

Anuria or Absence of Urine

1. Renal: Glomerulonephritis, pyelonephritis, polycystic kidney, chronic renal failure, nephrotoxic drugs, SLE etc.
2. Pre-renal: Diarrhea and vomiting, burns, blood loss, hypotension, septicemia, intravascular hemolysis, etc.
3. Obstructive: Calculi in kidney or urinary tract, blockage of ureters by malignancy or crystals, retroperitoneal fibrosis, accidental ligation during surgery, etc.

Retention of Urine

1. Neurological: Spinal cord diseases (Transverse and compression myelitis), cauda equina lesions, multiple sclerosis.
2. Genito-urinary
   • Penis: Phimosis
   • Urethra: Posterior urethral valves, foreign body, stones, stricture, rupture, spasm of the sphincter, etc.
   • Prostatic enlargement
   • Bladder: Atony, tumor, stone, or compression by fibroids or retroverted uterus.
   • Following parturition
3. Drugs: Sympathomimetic agents, salbutamol, terbutaline, anti-cholinergic drugs, etc.
4. Functional

What Are The Causes of Breathlessness or Dyspnea

1. Physiology:
   • Mountaineers,
   • Exercise,
   • Hyperpyrexia
   • Anemia.
2. Respiratory:
   • Airway obstruction
   • Bronchial asthma
   • Chronic obstructive lung disease
   • Pulmonary infections
   • Pulmonary edema
   • Pulmonary embolism
   • Bronchogenic carcinoma
   • Pleural effusion
   • Pneumothorax
3. Cardiac:
   • Acute myocardial infarction
   • Valvular heart disease
   • Left ventricular failure
   • Congenital cyanotic heart disease
4. Metabolic:
   • Diabetes
   • Uremia
   • Hypokalemia
5. Neurological
   • Respiratory center depression as in syringobulbia
   • Motor neuron disease
   • Guillain Barre syndrome
   • Bulbar polio
   • Myasthenia gravis
6. Psychogenic

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