Constipation

Question 1

Symptoms?

Answer 1

Decreased frequency in passing stools compared to normal bowel habit.

Straining when passing stools.

Pain when passing stools due to them being hard and solid.

Abdominal cramps.

Dry and hard stools.

Wind.

Nausea.

Patients may feel as though they can’t empty their bowels completely.

Question 2

Questions?

Answer 2

Current bowel habit?

How long have the symptoms been present?

Is the problem recurrent?

Consistency of stools?

Associated symptoms, including red flags?

Effect on quality of life?

History of colorectal cancer and IBD/IBS?

Question 3

Red flags?

Answer 3

Blood in faeces → refer to GP, could be a sign of colorectal cancer.

Sudden unexplained weight loss

Abdominal pain lasting multiple days → refer to GP, may be IBS or IBD.

Question 4

Treatment?

Answer 4

Lactulose (osmotic) - Lactulose:

• Adults and children 14+: starting dose 15-45mls twice daily
• 15-30mls maintenance dose
• Child 1 month to 1 year: 2.5 ml twice daily
• Child 1 to 5 years: 2.5 to 10 ml twice daily,
• Child/young person 5 to 18 years: 5 to 20 ml twice daily

OR

Senna (stimulant) - Senna pods:

• Adults and the elderly: 2 to be taken at bedtime as required
• For just 1 week
• Child 2 to 4 years: ½ to 2 tablets once daily
• Child 4 to 6 years: ½ to 4 tablets once daily
• Child/young person 6 to 18 years: 1 to 4 tablets once daily

OR

Boots Constipation Relief Suppositories

OR

Isphagula husk (bulk forming) - Fybogel:

• Adults and children under 12: 1 sachet in the morning and evening
• Fill glass with ~240mls water, drink preferably after a meal
• Not for children under 6 years