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Constipation
Purpose | Principles | How to Care for a Patient in Pain | Nutrition
Nausea and Vomiting | Constipation | Anxiety and Depression | Dyspnea
Fatigue | End-of-Life Decision-Making | Community Resources
How to Refer Patients | Communication | Links and References
Constipation Checklist
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Consider bowel obstruction, electrolyte abnormalities, drug-induced paralytic ileus
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Check for stool impaction
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Over-the-counter laxatives and stool softeners
| Class Of Drug |
Drug |
Usual Starting Dose |
Comments |
| Stool softeners |
Colace
(docusate sodium) |
200 mg/d |
mainly used to prevent constipation |
| Osmotic agents |
Sorbitol
(70 percent solution) |
30 ml hourlyx4
tid |
may cause abdominal cramps, flatulence |
|
Lactulose |
15-30 ml hourlyx4
tid |
may cause abdominal cramps, flatulence |
|
Miralax
(polyethylene glycol powder)
(requires prescription) |
17 gm daily |
may take 2-14 days, not recommended for chronic use |
|
Milk of Magnesia |
30-60 ml prn |
|
|
Glycerin suppository
(Fleet's) |
2-5.6 gm prn |
|
|
Phospho-soda
(Fleet's) |
20-45 ml |
once mix with 4 oz water; follow with 8 oz water |
| Bulk agents |
Metamucil
(psyllium) |
4-6 dm |
may cause constipation unless fluid intake is adequate |
|
Perdiem
(calcium polycarbophil) |
500-1000 mg/d |
|
| Stimulants |
Sennokot
(senna) |
2 tablets/d |
delayed onset of action |
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Dulcolax
(bisacody) |
5-15 mg |
oral, suppository and enema forms available |
Helpful Hints
- Consider prescribing stool softeners or laxatives for inpatient admissions, especially if patient is treated with narcotic analgesics
- A laxative agent or enema may be necessary before a stool softener or bulk agent, if patient is complaining of constipation
- Many over-the-counter single or combination drugs are widely available; Pericolace, Sennokot, Docusate, and senna, sugar-free sorbitol candy
- Increase fluids, dietary fiber and physical activity
Cancer Education & Information Center | 3015 N. Ballas Road | St. Louis, Missouri 63131 USA | 314.996.5800
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