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:

  • 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

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

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