what is constiaption ?
- constipation is symptosm of diificulty passign stools and a sensation of incompelte emptyign of the bowels. NICE defines this as less than 3 times a week
other symtopsm include excessive straining, lower abdoinal pain, or discomfort or bloating
what are bulk forming laxatives?
ideal for small, hard stools and fibre deficiency
swells in the gut to increase faecal mass to stimulate peristalsis
works within 24 hours but can take 2-3 days to take full effect
side effects include bloating, flatulence crampign and gut obstruction
recommendatiosn ocnlude encouragign fluid intake and not taking before bed
what are osmotic laxatives?
increase water in the volon by drawign fluid from the body or retains fluid administred with it
lactulose in particualr can cause osmotic diarrhoea of low feacal pH
macrogols sequester fludi in the bowel
generally works 2-3 days, wehreas lactulose works in 48 hours.
side effcest include discomfort, fltaulence, crampign and nusea
what are Stimulant Laxatives (Bisacodyl, Sodium Picosulfate, Senna, Glycerol and Docusate)
- Increases intestinal motility by irritating the gut lining.
◦ Glycerol suppositories work in 15–30 minutes.
◦ Works within 6–12 hours.
◦ Side effects include abdominal cramps.
◦ Excessive use can result in hypokalaemia. Continuous use can also cause lazy bowel.
what is dantron
Dantron is a stimulant but it is genotoxic and carcibogenic. it is only to be used in palliative care. side effecst can include red urine, local irritation adn excoriation
what is recommended in pregnancy?
bulk formign laxatives
failign this then an osmotic laxative
then bisacodyl. not seens as this can stimualte uterine contratiosn nearer to term. failign this then docusate or glycerol suppositories
