Contispation treatment lines

Question 1

what is treatment for short term constipation?

Answer 1

1st: bulk forming
2nd: osmotic laxative
3rd: addition of stimulant

Question 2

what is treatment for long term constipation?

Answer 2

1st: bulk forming
2nd: osmotic laxative- macrogol then lactulose

3rd: 2 different laxatives at highest tolerated dose

prucaloprode in women or lubrostone (stopped in 4 weeks if ineffective)

Question 3

how should you stop laxatives once regular bowel movement is achieved in chronic constipation?

Answer 3

ONE at a time

ideally stimulant laxative first.

Question 4

What is treatment of constipation in pregnancy and breastfeeding?

Answer 4

1st: Bulk forming
2nd: osmotic- lactulose
3rd: stimulant but only short term and Senna avoided near term or in history of unstable pregnancy.

Question 5

what is treatment of constipation in children?

Answer 5

dietary changes alone are not enough

avoid unprocessed bran which can cause bloating flatulence and decreased absorption of micronutrients

1ST: Osmotic- macrogol
2nd: stimulant
3rd: lactulose or stool softener

Question 6

Faecal impaction

what is it?

Answer 6

result of constant constipation when poop is stuck inside of your rectum.

treated in children >1 with:
osmotic -macrogol

if doesn’t work in 2 weeks = stimulant or if stools are hard used with osmotic such as lactose

Question 7

what is treatment in opioid induced constipation?

Answer 7

Osmotic laxative and stimulant

If in palliative care or unresponsive to others:
Methylnaltrexone

linaclotide