Constipation

Question 1

What is the definition of constipation?

Answer 1

Infrequent passage of stool (<3x weekly), often passed with difficulty, straining or pain.

Question 2

What are the causes of constipation?

Answer 2

Poor diet (low fibre), lack of exercise, poor fluid intake, IBS, old age, immobility, post-operative, anal or colorectal cancer, opioids, calcium channel blockers, anticholinergic (TCAs), hypercalcaemia.

Question 3

How do you investigate constipation?

Answer 3

FBC, U&Es, calcium, TFTs, PR exam, AXR to rule out obstruction.

Question 4

What is the management of constipation?

Answer 4

Reassurance, drink more, increase fibre, laxatives.

Question 5

What are the medications that can be used for constipation?

Answer 5

1. Bulking agents - bran, ispaghula husk
2. Stimulant laxatives - Bisacodyl, Senna
3. Stool softeners - arachis oil enemas
4. Osmotic laxatives - lactulose