John Damianos, M.D. Profile picture
@MayoClinicGIHep Gastroenterology & Hepatology Fellow. Yale Internal Medicine, Dartmouth Med. Microbiome, probiotics, brain-gut, diet, motility, IBD, MedEd 🇬🇷

Dec 15, 2022, 20 tweets

I gave a talk on inpatient bowel regimens today for the @YaleMed @YaleIMed residents and students, with additional 💎s on outpatient #constipation. Here are the slides!

💩 💩 💩

#MedTwitter #GITwitter #motility #MedEd @YaleIM_Chiefs @MayoClinicGIHep

Most inpatients require a bowel regimen. Our patients typically have most of the risk factors for #constipation!

#Constipation is more about symptoms than frequency! 🚽

It’s also a *symptom* (like chest pain), so need to figure out what’s causing it and treat accordingly.

Inpatient #constipation is associated with worse 🏥 outcomes.

@KewinSiah #StoolCanKill

Anatomy and physiology of defecation, with fun facts!

More on this here 👇🏽

Part 1: above and other- I think of 🔟 broad classes 💩

We should optimize these lifestyle factors for all patients with #constipation

👎Lubricants

👎Docusate is the worst! And that includes senna-docusate!

👍Bulk forming agents = FIBER

👍Stimulant laxatives

👍Osmotic laxatives

👍PAMORAs

👍Secretagogues and prokinetics

👍#Microbiome therapeutics

👍Miscellaneous

🍑Below: suppositories and enemas

Pitfalls

My approach for inpatient and outpatient #constipation 💩

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