Acute Medicine | Palliative care | Management of constipation

Management of constipation
Session overview
Description
This session provides a framework for the drug and non-drug management of constipation in end-of-life care patients.

This session was reviewed by Rachel Lee and was last updated in April 2023.

Learning objectives
By the end of this session you will be able to:

• name non-drug interventions that can help alleviate constipation
• list the main oral and rectal laxatives used in symptom management of constipation
• explain the mode of action of the different laxatives and their place in the treatment of constipation as single agents or in combination
• list the main adverse effects and contraindications in use of specific laxatives
• outline the treatment for faecal loading or impaction

Prerequisites
Before commencing this session you should complete:

• Assessment of constipation (215-0418)

Symptom management of patients with constipation, whether with cancer or non-malignant disease, starts with an initial assessment, involving identification of the underlying cause if possible. This allows the formulation of a management plan combining drug and non-drug measures which suits the individual patient.

Non drug interventions are also important in the management of constipation, and can contribute to improved gut function and help alleviate constipation. Not all of these are possible for those patients nearing the very end of life.

This session looks at the different laxatives and rectal measures that can be used, and explains their action. It also describes the management of faecal impaction, a particular problem for some end-of-life care patients.