Practice tips

• Special caution is required at the extremes of age when the symptoms and signs do not often reflect the seriousness of the underlying pathology.

• If an elderly patient presents with intense acute abdominal pain, inadequately relieved by strong parenteral injections, likely causes include mesenteric artery occlusion, acute pancreatitis and ruptured or dissecting aortic aneurysm.

• When an inflamed appendix ruptures, the abdominal pain improves for a significant period of time.

• A false sense of security can also occur with a perforated ulcer.

• Pus cells and red cells may be present in the urine with appendicitis when a pelvic appendix involves the bladder and a retrocaecal appendix involves the ureter.

• Consider diabetic ketoacidosis in a patient with abdominal pain, tenderness and rigidity and deep sighing respiration.

Constipation Prescription

Constipation Prescription

Did you ever think feeling angry and irritable could be a symptom of constipation? A horrible fullness and pressing sharp pains against the bladders can’t help but affect your mood. Sometimes you just want everyone to leave you alone and sleep to escape the pain. It is virtually impossible to be constipated and keep a sunny disposition. Follow the steps in this guide to alleviate constipation and lead a happier healthy life.

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