In So Long Constipation, Part 1 you will learn how to eliminate your constipation by learning what causes it and how this comes about. You will learn about the relationship between our daily environment and the gut. You will discover, in simple detail, how things like stress, industrial toxins and our modern diet and lifestyle influence the delicate balance of our mind-body system. You will familiarize yourself with the main aspects of this delicate balance in relation to gut function.

Three distinct types of contractions perform colonic motility functions. Rhythmic phasic contractions (RPCs) cause slow net distal propulsion with extensive mixing/turning over. Infrequently occurring giant migrating contractions (GMCs) produce mass movements. Tonic contractions aid RPCs in their motor function. The spatiotemporal patterns of these contractions differ markedly. The amplitude and distance of propagation of a GMC are several-fold larger than those of an RPC. The enteric neurons and smooth muscle cells are the core regulators of all three types of contractions. The regulation of contractions by these mechanisms is modifiable by extrinsic factors: CNS, autonomic neurons, hormones, inflammatory mediators, and stress mediators. Only the GMCs produce descending inhibition, which accommodates the large bolus being propelled without increasing muscle tone. The strong compression of the colon wall generates afferent signals that are below nociceptive threshold in healthy subjects. However, these signals become nociceptive; if the amplitudes of GMCs increase, afferent nerves become hypersensitive, or descending inhibition is impaired. The GMCs also provide the force for rapid propulsion of feces and descending inhibition to relax the internal anal sphincter during defecation. The dysregulation of GMCs is a major factor in colonic motility disorders: irritable bowel syndrome (IBS), inflammatory bowel disease (IBD), and diverticular disease (DD). Frequent mass movements by GMCs cause diarrhea in diarrhea predominant IBS, IBD, and DD, while a decrease in the frequency of GMCs causes constipation. The GMCs generate the afferent signals for intermittent short-lived episodes of abdominal cramping in these disorders. Epigenetic dysregulation due to adverse events in early life is one of the major factors in generating the symptoms of IBS in adulthood.

Constipation: A Practical Approach to Diagnosis and Treatment serves as an unmet resource for physicians and other health care providers, including trainees and students, who see patients with constipation. The text reviews pathophysiologic mechanisms and details evaluation and management strategies. The volume also enables the reader to identify epidemiologic factors and quality of life parameters for patients with constipation, discuss differences in pathophysiologic mechanisms for different etiologies of constipation, recognize primary causes of constipation, and assess special considerations related to the symptom of constipation including presentations in the elderly, in pregnant women, in patients with systemic diseases, and patients with a history of abuse. Written by thought leaders and recognized experts in gastrointestinal motility and medical education, Constipation: A Practical Approach to Diagnosis and Treatment is of great value and utility for gastroenterologists, primary care physicians, gynecologists, nurse practitioners, physician’s assistants, as well as fellows and residents.

The most comprehensive psychiatric nursing care planning text available assists students and practitioners in providing effective care in a variety of settings. Clear presentation of information, consistent use of the nursing process, correlation of nursing and medical diagnoses, and prioritization of interventions make this text an invaluable resource. Grounded in the latest classification of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) and the most current list of NANDA-approved nursing diagnoses, this text covers a wide range of disorders, their psychopathology, and appropriate nursing interventions with rationales. Care plans use real clinical situations and include therapeutic and nontherapeutic dialogue examples to familiarize nurses with likely scenarios and equip them with the tools they need to feel confident in any clinical setting. The first chapter, The Nursing Process, effectively describes the central principles of psychiatric nursing practice in detailing the ANA's six-step nursing process along with additional information on therapeutic nurse-client communication skills, client history and assessment tools, NIC and NOC, and more. The six-step nursing process format is maintained throughout to emphasize a practice-oriented, problem-solving approach to psychiatric care. Major psychiatric disorders are reviewed consistently and completely with sections including Etiology, Epidemiology, Assessment and Diagnostic Criteria, Interventions, and Prognosis and Discharge Criteria. With this basis of knowledge, relevant care plans are offered in the second section of each chapter. Care plans based on DSM-IV-TR medical and NANDA nursing diagnoses are logically and consistently organized with Assessment Data, Outcome Criteria, Planning and Implementation, and Evaluation sections. Assessment Data sections include detailed related factors (etiology) and defining characteristics or risk factors as appropriate for the specific diagnosis. Outcome Criteria sections give the reader clear indications of the desired end state. Planning and Implementation sections list specific, relevant, and practical nursing interventions with rationales in a clear, comprehensible two-column format. UNIQUE! Therapeutic and non-therapeutic dialogue examples are presented throughout to promote more effective client communication. Evaluation sections state the role of outcome evaluation as a critical and ongoing step in the nursing process. Client and Family Teaching boxes include Nurse Needs to Know and Teach Client and Family sections covering all aspects of post-treatment instructions for clients and caregivers. DSM-IV-TR boxes list all related DSM-IV-TR diagnoses for quick reference. Helpful appendices contain information and strategies that are timely and useful in the care of clients with mental and emotional disorders including such topics as psychiatric and psychosocial therapies, grief and loss, spirituality, and many more.