Things to note: - Dietary advice preferably by dietician.
- Dietary measures i.e. balanced diet with unprocessed foods, e.g. cereals, legumes, fruit and vegetables.
- Correct dehydration. Ensure adequate fluid intake.
- Wheat bran: introduce slowly and take with sufficient fluid.
- Side-effects include: bloating, cramps and flatulence.
- Manual removal of impacted stools.
- Encourage regular bowel habits.
- Physical exercise.
Medical Treatment:
Osmotic laxatives - Lactulose, oral, 10-20 mL daily.
- Titrate to effect i.e. up to 60 mL daily.
Stimulant laxatives For short term use only, except in the elderly where long-term treatment may be indicated:
- Sennosides A and B, oral, 7.5-15 mg at night 2-3 times a week for up to 4 weeks.
Polyethylene glycol-based purges For acute bowel preparation or for chronic constipation on specialist advice.
Saline or phosphate enemas- May occasionally be indicated in acute constipation.
When to refer: - For investigation for organic disease.
