Constipation

Question 1

Lifestyle advice for constipation?

Answer 1

Increase fibre intake - oats, seeds, frui
Drink plenty of water
Stay active
Don’t strain.
Avoid alcohol
Don’t ignore urge to go

Question 2

Referral points for constipation.

Answer 2

Watery diarrhoea - overflow diarrhoea
Blood in faeces
Persistent fatigue
Unexplained weight loss
Drug use which can cause constipation - opioids, iron supplements, anti-nausea, antihypertensives,
CLOZAPINE MAY REQUIRE A&E REFERAL - fatal faecal impaction

Question 3

What are the types of laxatives, examples, and their onset of action?

Answer 3

Osmotic laxatives: lactulose, macrogol (Movicol/laxido).
Take 2-3 days.

Stimulant laxatives: bisacodyl, senna.
Take 6-12 hours to work.

Softening laxatives: docusate.
takes 1-2 days to work.

Bulk-forming:methylcellulose, ispaghula husk (Fybogel).
Takes 2-3 days to work.

Question 4

OTC constipation treatment.

Answer 4

Normally:
1. Bulk-forming laxative
2. + osmotic laxative.
3. stop osmotic. + stimulant laxative.