Drug Status Key

  • Preferred
  • On Formulary
  • Specialist Initiation
  • Shared Care
  • Hospital Only
  • Under Review
  • New on System

Guidelines for the Management of Constipation

For guidance on the management of constipation in children and young people see NICE CG 99 Constipation in children and young people

Where possible stop any drugs likely to cause constipation

Ensure patient is properly positioned when sitting on the toilet as correct posture can make defecation easier and more comfortable.

Dietary advice – high fibre content diets in association with adequate fluid intake (minimum 1.5 litres per day) are effective in increasing stool weight and bowel movement frequency. It should be tried for at least a month before its effects are determined. It should be used with caution in patients who have obstructive symptoms or faecal impaction. Caution: a high fibre diet may increase bloating.

Soft Stool

  1. Senna 2 –4 tablets at night PRN
  2. Glycerol suppository PRN
  3. Sodium Citrate micro-enema PRN


Hard Stool

  1. Docusate 100mg TDS
  2. Sodium Citrate micro-enema PRN
  3. Laxido® sachets. Use 1 to 3 sachets daily in divided doses in water as per manufacturer’s instructions.


Chronic Constipation

Dietary advice – high fibre content diets in association with adequate fluid intake (minimum 1.5 litres per day) are effective in increasing stool weight and bowel movement frequency. It should be tried for at least a month before its effects are determined. It should be used with caution in patients who have obstructive symptoms or faecal impaction. Caution: a high fibre diet may increase bloating.

The use of laxatives is not always necessary. However laxative use may be appropriate if:

  • No response to dietary changes.
  • There is faecal impaction.
  • Constipation or painful defecation is associated with illness, surgery or during pregnancy.
  • The patient is elderly or has a poor diet.
  • Constipation is drug induced.
  • Patient has a medical condition in which bowel strain is undesirable.

Also in preparation for investigations or procedures.

Laxatives – The choice of laxative should be based on symptoms, patient preferences, side effects and the cost.

Faecal impaction

Laxido® 8 sachets in 1000ml water & consumed over 6 hours. Used for 3 days then re-assess.

 

 

Please note, sample information has been entered into Chapters 1 and 2 only and although fairly clinically accurate, it is not guaranteed. The information was entered during April and May 2017 and drugs will have subsequently been randomly added during telephone demonstrations.