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Palliative cancer care - constipation - Management
How should I treat constipation?
- Confirm that the person is constipated and exclude or manage bowel obstruction, anal fissure, painful haemorrhoids and local tumour.
- Begin treatment by relieving any faecal loading/impaction.
- Encourage the person to increase their physical activity and their fluid and dietary fibre intake if appropriate.
- Ensure adequate privacy and sufficient help to get to the toilet.
- Start treatment with a combination of a stimulant plus a softening laxative.
- If colic is a problem, use a softening laxative for a few days, and then add in the stimulant.
- A stimulant laxative alone may be sufficient if the rectum is full of soft faeces.
- Titrate the dose every few days to achieve comfortable defecation.
- It may be necessary to exceed the licenced dose and frequency.
- Adjust the laxative dose in line with the opioid dose.
In depth
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