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CONDITION/DISORDER SYNONYMS
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PREFERRED PRACTICE PATTERN
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As of June, 2014, the APTA Guide to Physical Therapist Practice does not include practice patterns for organ system pathology; therefore, the associated or secondary musculoskeletal, cardiovascular/pulmonary, or potential neuromuscular patterns would be indicated.
4C: Impaired Muscle Performance1
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PATIENT PRESENTATION
A 40-year-old mother of three reports difficulty passing bowel movements (BMs). Symptoms have gradually worsened over the past 5 years since the birth of her third child. During that vaginal delivery, she suffered a fourth degree perineal tear which extended into the anal sphincter and rectal mucosa. She is now having BMs once every 3 to 4 days, as compared to daily just a few years ago. She reports that she has to “splint” her perineum with her hand, in order to evacuate her bowels.
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General Considerations
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Constipation is a symptom, and is not a disease
Constipation is the most common digestive complaint
The chief cause of constipation is inadequate alimentary fiber content
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In the United States, estimates are between 2% and 34%
16.7% (1 in 6 people)
6% of children
80% of nursing home residents
In children: More common in males than females
In adults: More common in females than males
Very common during pregnancy and postpartum
In elders: Equally as common in males and females
More common in non-Whites than Whites
More than three million prescriptions per year for laxatives; over $725 million on over-the-counter laxatives
In patients with constipation, 15% to 38% have obstructed defecation3...