Bulk forming laxatives

Question 1

Bulk forming laxatives - examples

Answer 1

Bran

Ispaghula husk

Question 2

Bulk forming laxatives - side effects

Answer 2

flatulence
bloating
cramping

Question 3

Outline the stepwise treatment for constipation

Answer 3

1) dietary changes = exercise + high fibre diet + regular meals + hydration + don’t hold it in

if step 1 ineffective, move to step 2

2) bulk-forming laxative, ensuring adequate fluid intake.

If stools remain hard, add or switch to step 3

3) osmotic laxative

If stools are soft but difficult to pass or the person complains of inadequate emptying, move to step 4

4) stimulant laxative should be added

Question 4

Outline the stepwise treatment for faecal impaction

Answer 4

treatment of faecal impaction depends on the stool consistency

hard stools = high dose of an oral macrogol (osmotic laxative)

soft stools OR hard stools after a few days treatment with a macrogol = oral stimulant laxative should be started or added to the previous treatment.

If the response to oral laxatives is inadequate then consider suppositories (rectal administration) or mini enema