Constipation

• 30g of fibre a day
• Appropriate toilet habits
• First line is Fybogel, bulk-forming laxative which promotes water absorption
• Second line is osmotic laxatives for example lactulose or macrogol
• Third line is stimulant laxative such as senna
• Fourth line is stool softeners such as docusate sodium
• Symptoms of constipation: Difference in normal bowel movements, bloating, abdominal pain, and straining, a feeling of obstruction
• Less than 4 bowel movements per week or less than normal
• Children younger than 6 should be referred to a doctor
• Patients taking fybogel should be drinking more than their normal amount
• Fybogel does take around a day to work but can be two
• Stimulant laxative have a quicker action time however should only be used for up to a week
• If laxatives do not help for a week, speak to doctor
• Osmotic laxatives can be used in pregnancy and children however cause flatulence
• Check for medical constipation e.g opioids, antidepressants, laxative abuse
• Refer if weightloss, blood in stool or dehydration
• Wholemeal breads and cereals, green veg and fruit
• Elderly patients are more prone to constipation
• Pregnancy hormones can cause constipation