Constipation

Question 1

Red flags for constipation

Answer 1

Constipation associated with:
- abdo pain
-Anaemia
- Weight loss
- Blood in stools
- New onset >50 years old

Question 2

What electrolyte disturbance can abuse of laxatives lead to?

Answer 2

Hypokalaemia

Question 3

1st-line laxative in pregnancy?

Answer 3

Bulk-forming laxatives

Question 4

Name the bulk-forming laxatives

Answer 4

Fybogel (Ispaghula Husk)
Methylecullose
Bran
Sterculia

Question 5

Side effects of bulk-forming laxatives?

Answer 5

Flatulence
Bloating
Cramps

Question 6

Onset of action of bulk-forming laxatives

Answer 6

72h

Question 7

Name the stimulant laxatives

Answer 7

Sodium picosulfate
Bisacodyl
Senna

Question 8

When are stimulant laxatives best taken?

Answer 8

At night- so bowel movement can be had in the morning

Question 9

Name the stool softeners

Answer 9

Docusate and glycerol

Question 10

Low-term side effect of stool softeners?

Answer 10

Decreased absorption of vitamins ADEK

Question 11

Which laxative should be used with caution in patients with fluid/electrolyte disturbances?

Answer 11

Linaclotide

Question 12

Linaclotide licensing

Answer 12

Used in constipation in mild-moderate IBS

Question 13

Which laxative is CI in intestinal obstruction?

Answer 13

Bulk-forming laxatives

Question 14

Which laxative is cautioned in intestinal obstruction?

Answer 14

Stimulant laxatives

Question 15

Which stimulant laxatives are solely indicated for terminally ill patients and why?

Answer 15

Co-danrathmer and co-danthrusate as carcinogenic

Question 16

Which laxative has both stool softening properties and stimulant laxative properties?

Answer 16

Docusate

Question 17

Which laxative should not be used in opioid-induced constipation?

Answer 17

Bulk-forming laxatives

Question 18

1st line treatment for opioid induced constipation

Answer 18

Stimulant + osmotic laxative

Question 19

Licensing of Prucalpramide?

Answer 19

Used for constipation in women where 2 other agents for a minimum of 6 months, have failed

Question 20

1st line for short-term constipation

Answer 20

Bulk-forming laxatives

Question 21

Which laxative should be avoided in near term or unstable pregnancies?

Answer 21

Senna

Question 22

How does treatment of constipation differ in children than with adults?

Answer 22

Lifestyle modifications should be tried first inn adults but in children, lifestyle measures should be implmented alongside laxative

Question 23

1st line laxative treatment in children

Answer 23

Macrogol

Question 24

2nd line laxaive in children

Answer 24

Stimulant laxative