GIT - Approach for Constipation

<p> #GIT</p><p><br /></p><p>#Constipation approach :</p><p>প্রথমে দেখে নেয়া এটা constipation এর criteria fulfill করে কিনা।</p><p><br /></p><p>এটা  হতে পারে functional (80%)</p><p>→অনেক দিন ধরে সমস্যা। fever,wt loss,anaemia,per rectal bleeding  নাই</p><p>হতে পারে organic cause(20%) </p><p>--features of obstruction,wt loss,anaemia,fever,per rectal bleeding থাকতে পারে। </p><p><br /></p><p>যদি functional হয় হতে পারে ঃ</p><p><br /></p><p>Normal Transit constipation (IBS Type)</p><p>এদের defecation frequency normal. Dx criteria ↓</p><p>(নিচে ছবি   দেয়া আছে)</p><p><br /></p><p>Slow Transit constipation </p><p>(Young aged female, 5- 6 দিন পর পর টয়লেট হয়, </p><p>টয়লেটের কোন urge থাকে না, hard, dry stool)</p><p><br /></p><p>Pelvic floor dyssynergia</p><p>(Straining থাকে,persistent urge থাকে, hard pillet shape stool,মাঝে মাঝে   manual evacuation করতে হয়)</p><p>Functional গুলাকে কিভাবে differentiate করব?</p><p>1 টা sign আর 1টা symptom </p><p>Urge  কেমন ঃ </p><p>Normal transit – normal urge</p><p>Slow transit – no urge(almost)</p><p>Pelvic floor dyssynergia- persistant urge</p><p><br /></p><p>DRE:</p><p>পেশেন্ট  bear Down করলে anal sphincter paradoxically contract করলে৷৷৷  এটা pelvic floor dyssynergia </p><p>Secondaary কিছু causes :Hypothyroid, hypercalcemia, DM. Slow transit constipation এর নত feature নিয়ে আসতে পারে। </p><p> </p><p><br /></p><p>#Management </p><p><br /></p><p>IBS type constipation /Slow transit constipation </p><p><br /></p><p>Non pharmacological: (Common for all)</p><p>Lifestyl change </p><p>Regular food habit</p><p>পর্যাপ্ত পানি,শাক সবজি(20-40g/day) খাবে</p><p>লাইফ style modifications, Wt loss  করতে হবে।</p><p>Gastro-colic reflex কে কাজে লাগাবে। </p><p>খাবারের 20- 30মিনিট পর টয়লেটে বসে থাকবে 5- 10 মিনিট সকালে এবং রাতে( mainly slow transit constipation এ ভাল benifit পাওয়া যায়) </p><p><br /></p><p>1 মাস পর if Not improved </p><p>→pharmacoloical treatment </p><p><br /></p><p>synthetic bulk forming agent[Ispaghula husk(ভুসি)৷  ]</p><p>কিভাবে খাবেন: এক গ্লাস পানির সাথে 1 sachet ভুসি মিশিয়ে সাথে সাথে খেয়ে ফেলতে হবে।  বেশিক্ষন ভুসি পানির সাথে ভিজিয়ে রেখে খেলে কাজ হবে না তেমন। কারন সে already পানি absorb করে বসে থাকবে gut এ গিয়ে আর পানি absorb করতে পারবে না।</p><p><br /></p><p>→if not improved </p><p>Osmotic laxative (lactulose)</p><p>Syp.avolac 6tsf @night or 3/4 tsf tds</p><p><br /></p><p>→If not improved </p><p>Cl channel activator (lubiprostone)- Gut এ পানি ধরে রাখবে-stool কে soft করবে</p><p>Tab.lubigut 24mcg 1+0+1</p><p><br /></p><p>→if not improved </p><p>5HT4 agonist(Prucalopride) -Colon এর motility বাড়াবে</p><p>tab.caloprid 1 or 2mg  0+0+1</p><p><br /></p><p>এই পর্যন্ত এক ই। IBS type /slow transit type এর ক্ষেত্রে। </p><p><br /></p><p>→if not improved </p><p><br /></p><p>In IBS variety constipation :</p><p>Tab.Duloxatine 30-60mg 0+0+1</p><p><br /></p><p>Abdominal boating থাকলে:</p><p>Gluten free food(বেকারি খাবে না)</p><p>Tab.Rifagut 600mg daily -14 days</p><p><br /></p><p>In slow transit constipation :</p><p>Stimulant drug(Bisacodyl)</p><p>Tab.Duralax 5mg 0+0+1 এর পর ও ভাল না হলে</p><p>tab.Neostigmine  এরপরও ভাল না হলে surgery</p><div class="separator" style="clear: both; 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GIT - Approach for Constipation

 #GIT #Constipation approach : প্রথমে দেখে নেয়া এটা constipation এর criteria fulfill করে কিনা। এটা  হতে পারে functional (80%) →অনেক দিন ধরে ...

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ইসলামী বিশ্বকোষ Apk download

<p> <b style="background-color: white; border: 0px; color: red; font-family: inherit; font-size: large; font-stretch: inherit; font-style: inherit; font-variant: inherit; line-height: inherit; margin: 0px; overflow-wrap: break-word; padding: 0px; position: relative; vertical-align: baseline;"><a href="https://apkaio.com/download-apk/com.islamboi.rizwan" style="border: 0px; color: #0eb975; font-family: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; overflow-wrap: break-word; padding: 0px; position: relative; text-decoration-line: none; vertical-align: baseline;">ইসলামী বিশ্বকোষ ও আল-হাদিস অ্যাপ</a> [Download]</b></p><a href="https://m.apkpure.com/%E0%A6%87%E0%A6%B8%E0%A6%B2%E0%A6%BE%E0%A6%AE%E0%A7%80-%E0%A6%AC%E0%A6%BF%E0%A6%B6%E0%A7%8D%E0%A6%AC%E0%A6%95%E0%A7%8B%E0%A6%B7-%E0%A6%93-%E0%A6%86%E0%A6%B2-%E0%A6%B9%E0%A6%BE%E0%A6%A6%E0%A6%BF%E0%A6%B8-al-hadith/com.islamboi.rizwan/download?from=amp_info" style="background-color: white; color: #01b8c0; text-decoration-line: none;"><span style="font-size: medium;"><img alt="ইসলামী বিশ্বকোষ অ্যাপ (Install)" height="320" id="Image2_img" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiv_afE3EqjpAucrjXWq1bIewEsL6UiErEYEQ65FMw4zLOBWxjEOuH2l6FgiFsXt6i3r0LBbEVZeMSxhByeY3AE6guLydfagsgMBxiVTK0rgAXvkOlPZL3hXX4fTcN0gFXkXZhIXMn4swE/w320-h320/PicsArt_03-02-11.16.42.webp" style="border-width: 0px; height: auto; max-width: 100%;" title="ইসলামী বিশ্বকোষ ও আল-হাদিস অ্যাপ [Download] ইসলামী বিশ্বকোষ অ্যাপ (Install)" width="320" /></span></a><br /><span style="font-size: medium;"><br /></span><span style="font-size: large;">অন্যান্য সার্ভারঃ</span><br /><span style="font-size: medium;"><br /><ol><li><a href="https://m.apkpure.com/%E0%A6%87%E0%A6%B8%E0%A6%B2%E0%A6%BE%E0%A6%AE%E0%A7%80-%E0%A6%AC%E0%A6%BF%E0%A6%B6%E0%A7%8D%E0%A6%AC%E0%A6%95%E0%A7%8B%E0%A6%B7-%E0%A6%93-%E0%A6%86%E0%A6%B2-%E0%A6%B9%E0%A6%BE%E0%A6%A6%E0%A6%BF%E0%A6%B8-al-hadith/com.islamboi.rizwan/download?from=amp_info"><span style="font-size: medium;">ইসলামী বিশ্বকোষ ও আল হাদিস - APK Pure</span></a></li><li><a href="https://apkaio.com/download-apk/com.islamboi.rizwan" style="font-style: inherit; font-variant-caps: inherit; font-variant-ligatures: inherit;">ইসলামী বিশ্বকোষ ও আল হাদিস - Apkaio</a><span style="font-size: large; font-style: inherit; font-variant-caps: inherit; font-variant-ligatures: inherit;"> </span></li><li><a href="https://steprimo.com/download/Y29tLmlzbGFtYm9pLnJpendhbg==/OWIzYWVhYWRhOWJjZTdlZjFjYTVmNmNiNWI1OTEwNGM/" style="font-style: inherit; font-variant-caps: inherit; font-variant-ligatures: inherit;"><span style="font-size: medium;">ইসলামী বিশ্বকোষ ও আল হাদিস - Steprimo.Com</span></a></li><li><a href="https://xn-------al-hadith-dk2am0s8a51a0da5b5fj7g2atp1a0loaunr50bjc.apk.cafe"><span style="font-size: medium;">ইসলামী বিশ্বকোষ ও আল হাদিস - Apk Cafe</span></a></li><li><a href="https://www.99images.com/apps/books-reference/com.islamboi.rizwan/download?amp=1"><span style="font-size: medium;">ইসলামী বিশ্বকোষ ও আল হাদিস - 99images</span></a></li><li><a href="https://apkfun.com/down_%E0%A6%87%E0%A6%B8%E0%A6%B2%E0%A6%BE%E0%A6%AE%E0%A7%80-%E0%A6%AC%E0%A6%BF%E0%A6%B6%E0%A7%8D%E0%A6%AC%E0%A6%95%E0%A7%8B%E0%A6%B7-%E0%A6%93-%E0%A6%86%E0%A6%B2-%E0%A6%B9%E0%A6%BE%E0%A6%A6%E0%A6%BF%E0%A6%B8-Al-Hadith.27741981.html">ইসলামী বিশ্বকোষ ও আল হাদিস - Apkfun</a></li><li><a href="https://www.luckymodapk.com/al-hadith-mod/com.islamboi.rizwan">ইসলামী বিশ্বকোষ ও আল হাদিস - luckymodapk</a></li><li><a href="https://apk.support/old-apk-from-google-play/com.islamboi.rizwan/"><span style="font-size: medium;">ইসলামী বিশ্বকোষ ও আল হাদিস - Apk.Support</span></a></li><li><a href="https://www.apk4now.com/apk/357167/-----------al-hadith/download">ইসলামী বিশ্বকোষ ও আল হাদিস - Apk4now</a></li><li><a href="https://www.sunni-encyclopedia.com/2022/03/App.html"><span style="font-size: medium;">ইসলামী বিশ্বকোষ ও আল-হাদিস - Encyclopedia</span></a></li></ol></span>

ইসলামী বিশ্বকোষ Apk download

  ইসলামী বিশ্বকোষ ও আল-হাদিস অ্যাপ  [Download] অন্যান্য সার্ভারঃ ইসলামী বিশ্বকোষ ও আল হাদিস - APK Pure ইসলামী বিশ্বকোষ ও আল হাদিস - Apkaio  ...

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