Constipation

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1. check:

    1. CBC, FBS, Ca, P, PTH, ESR, TSH, OB

    2. Abdominal X-ray & Chest X-ray

2. Treatment

    1. Bulking agents:

        1. Sachet psyllium qd or bid #30

    2. Osmotic

        1. Sachet PEG 10 mg qd #20

            1. long-term use may cause electrolyte imbalance

        2. Syrup lactulose 10mg/15ml #1 15-30 cc bid

            1. cause bloating

            2. in pregnancy and CKD is safe

        3. Supp glycerin qhs #10

        4. Susp MOM #1 weight*2 cc or 15-30 cc qd or bid

    3. provocative

        1. Supp Bisacodyl 5, 10 mg qhs #5

        2. syrup Figan 5cc qd #1

        3. Syrup Caster oil

        4. Syrup senalin

    4. for long-term treatment, Lactulose and PEG are good choices

    5. For children or pregnant females use Lactulose or Glycerin

    6. Do not use Lactulose in DM and Bowel obstruction

    7.