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Constipation - Management
How should I treat chronic constipation in adults?
- Begin by relieving faecal loading/impaction, if present.
- Set realistic expectations for the results of treatment of chronic constipation.
- Advise people about lifestyle measures — increasing dietary fibre (including the importance of regular meals), drinking an adequate fluid intake, and exercise.
- Adjust any constipating medication, if possible.
- Exclude underlying causes (e.g. hypothyroidism, metabolic disease, anal fissure, haemorrhoids).
- Laxatives are recommended:
- If lifestyle measures are insufficient, or whilst waiting for them to take effect.
- For people taking a constipating drug that cannot be stopped.
- For people with other secondary causes of constipation.
- As 'rescue' medicines for episodes of faecal loading.
- Laxatives are used as in short-duration constipation.
- Adjust the dose, choice, and combination of laxative to produce comfortable defecation with soft, formed stools once or twice a day.
In depth
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