Treatment of Constipation

Thursday, 03 March 2005 13:35
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GENERAL MEASURES:

High Fibre Diet: increases the bulk of the stool and affects faecal
transit time. About 30g per day - (e.g. fruit, vegetables, wholemeal bread,
cereals and grain foods), should be tried for at least one month before
effects on constipation are determined, although most will notice an effect
within 3 to 5 days.

If adequate fluid intake is not possible, avoid increasing
dietary fibre. Side effects include flatulence, bloating and distension but
should diminish after a few months, once the bowel has adjusted.

  • 2 litres of water, taken each day (approx. 8 glasses/12 cups)
  • High fibre is NOT recommended in patients with megacolon or hypotonic colon/rectum as it will not respond to bulk in the colon; and
    increasing bulk may lead to obstruction in those taking opioids.
  • Coffee and tea have diuretic properties, therefore may make
    constipation worse.
  • Exercise/ maintaining mobility if possible
  • LAXATIVES:

    Laxatives are non-absorbable chemicals or materials designed to increase
    the bulk of the stool, or to lubricate passage of the stool, or to stimulate the
    bowel wall either directly or indirectly.
     
    Bulking agents such as Isphagula husk, Psyllium, may be used but
    adequate fluid intake is essential to avoid obstruction.

    Faecal softeners / emollient laxatives (e.g. docusate):

    Osmotic laxatives (e.g. phosphate enemas):

    Stimulant laxatives (e.g. senna, bisacodyl):
     
    Directly stimulate colonic nerves to cause movement of the faecal mass.

    TIME FOR ORAL LAXATIVES TO BE EFFECTIVE: