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Acute constipation – short duration lasting less than 4 weeks Chronic constipation - stool frequency of less than three per week that lasts several months Opioid-induced constipation – constipation caused as a side-effect of opioid medications Faecal impaction/loading – accumulation of putty-like or hardened stools in the rectum or sigmoid.
The aim of laxatives is to increase stool frequency or ease of stool passage by increasing stool water content (directly by osmotic or intestinal secretory mechanisms) or by accelerating bowel transit. Bulk-forming laxatives (containing soluble fibre) act by retaining fluid within the stool and increasing faecal mass, stimulating peristalsis ...
The recommendations on the initial management of constipation are based on the Consensus statement on constipation in older people [Emmanuel, 2017], and expert opinion in a review article on constipation in the document the European Society for Neurogastroenterology and Motility's Guidelines on functional constipation in adults [Serra, 2020], expert opinion in the BMJ Best Practice review ...
Treatment of faecal impaction. 1st line (Oral): Macrogols (e.g. Laxido, Movicol) 8 sachets daily in divided doses. PLUS/MINUS. Senna Tabs (=7.5mg sennosides / tablet) 2 - 4 tablets at night Bisacodyl Tabs, 5-10mg at night (increased if necessary to 20mg at night) Use where stools are soft but difficult to pass.
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Laxatives are a type of medicine that can treat constipation. They're often used if lifestyle changes, such as increasing the amount of fibre in your diet, drinking plenty of fluid and taking regular exercise, have not helped. Laxatives are available to buy from pharmacies and supermarkets. They're also available on prescription from a doctor.
Table 1. Factors affecting choice of laxative. Laxative. Time to effect. Points to note. Bulk forming laxatives. Ispaghula (also known as psyllium) 2–3 days. Useful first-line choice in adults when it is difficult to get adequate dietary fibre; better tolerated than bran.
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1. Management of constipation in adults: acute and chronic treatment pathways 2. Management of constipation in adults patients: opioid-induced constipation pathway 3. Management of constipation in children: NICE Clinical Guideline 99 Please note: NHS England have advised CCGs that a prescription for the treatment of
