Constipation/ Faecal Impaction
A condition characterised by a change in usual bowel habits and dry, hard stools. There is a decreased frequency of bowel action and patients should be assessed individually. Constipation may have many causes:
» incorrect diet (fibre and fluid);
» lack of exercise;
» old age;
» psychogenic disorders
chronic use of enemas and laxatives;
cancer of the bowel;
» certain drugs;
» lower bowel abnormalities;
ignoring the urge;
behavioural children. problems in
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.
• Lactulose, oral, 10–20 mL daily. o 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.
» For investigation for organic disease.
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