A 75 year-old woman has had regular daily by Dr. Laurence Bailen

Question 16 / 32: A 75 year-old woman has had regular daily bowel movements throughout her entire life. She comes to your office because she has noted a marked change in her bowel habits. She now will only have a bowel movement every third day and the stool is hard and difficult to pass. She has recently been taking a morphine derivative due to back pain. She has no known neurologic disorder and leads a very active life style. A colonoscopy is normal.

Which of the following most likely has caused her symptoms of constipation?

Irritable bowel syndrome

Colonic pseudoobstruction

Inadequate fiber intake

Narcotic use

Large rectocele

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Explanation:

Narcotics, including morphine and its derivatives, are a well known cause of constipation. Irritable bowel syndrome would be very unlikely in a 75 year old. The clinical history does not suggest that any of the other answers would be possible.

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Gastrointestinal Pathophysiology Self-Assessment

Author:

Dr.Laurence BailenProfessor

Tufts University School of Medicine

USA

Access: Public

Attribution: Laurence Scott Bailen, Tamsin Knox, Paul Abourjaily, Fredric D. Gordon,Marshall Kaplan,Andrew G. Plaut. PPY 222 Gastrointestinal Pathophysiology, Spring 2007. (Tufts University OpenCourseWare), http://ocw.tufts.edu/Course/47 (Accessed 3 May, 2014). License: Creative Commons BY-NC-SA

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