• Advise the person about lifestyle measures — increasing dietary fibre, drinking an adequate fluid intake, and exercise.
• Offer additional oral laxatives if dietary measures are ineffective, or while waiting for them to take effect.
• Start treatment with a bulk-forming laxative (adequate fluid intake is important).
• If stools remain hard, add or switch to an osmotic laxative.
• If stools are soft but the person still finds them difficult to pass or complains of inadequate emptying, add a stimulant laxative.
• Advise the person that laxatives can be stopped once the stools become soft and easily passed again.

The literature tends to focus on chronic constipation and does not discuss the management of short duration constipation as a particular clinical problem, although it is common in primary care.

These recommendations therefore reflect what is commonly regarded as good practice in UK primary care.

• Dehydration, reduced levels of physical activity, and low levels of dietary fibre are associated with constipation. However, the clinical impression is that increasing fluids above an adequate daily intake, increasing exercise, and advice to increase dietary fibre does not always relieve constipation.
• For all laxatives, trial evidence on efficacy and safety is limited. This is mainly because these agents have been in use for a long time, clinical trials were far less robust at the time they were originally licensed, and few new clinical trials have been done.