Older adult inpatient management of constipation

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General aim should be to move bowels three times per week. If not moved after 2 days in hospital, assessment for constipation required.

Consider the following throughout admission:

Non-pharmacological
  • Dietary advice
  • Prunes and porridge
  • Fruit/ Fruit juice (caution in diabetes)
  • Dietary fibre intake (menu choices)
  • Aiming 1.5 to 2 litres of fluid daily
  • Hot, decaffeinated drinks
  • Maintain activity as able
Best position


Consider timing: 30 minutes after breakfast and hot drink
Try to avoid delay when the urge develops, and avoid rushing the person

Undertake medication review

Identify constipating medicines including:

  • Aluminium containing antacids
  • Antidiarrhoeals
  • Iron and calcium supplements
  • Opioid analgesics
  • Calcium channel blockers: diltiazem
  • Antimuscarinics: oxybutynin, amitriptyline, imipramine
  • Antipsychotics: amisulpride, chlorpromazine
  • Gabapentin/pregabalin, carbamazepine, etc
Medical review including PR

Consider laxatives:

  • 1st line Laxido©  (osmotic laxative)
    Usual starting dose of 1 sachet twice daily
  • 2nd line docusate (softener) or sennosides (stimulant) and treat as per usual
Suppositories/enemas

Where stools are soft but difficult to pass (or no enteral route available) use bisacodyl suppositories 10mg daily and/or glycerol suppositories 4g daily

For hard stools use sodium phosphate retention enema or Micralax Micro-enema in morning

Printable poster

Ward Bowel Chart

Editorial Information

Last reviewed: 03 December 2020

Next review: 03 December 2023

Approved By: TAM subgroup of ADTC

Reviewer Name(s): Associate Specialist, Medicine for Elderly and Pharmacist, Medicine for the elderly

Document Id: TAM462