Clinical practice point. Before resorting to laxatives, try:
- Increasing daily fibre intake, about 30g fibre per day. Further information is available on how to do this on the NHS Choices website How to get more fibre into your diet
- Add bulking agents, e.g. wheat bran, to diet – these will help to make the stools softer and easier to pass, although bran and fibre can make bloating worseN.B. In order to minimise bloating and discomfort, dietary fibre and bulking agents should be introduced gradually into the diet
- Drink plenty of water
- Exercise regularly
- Make time to establish a regular bowel routine by utilising the gastro-colic reflex (i.e. making time to use the toilet after meals)
- Sitting in the correct position on the toilet
- Unless otherwise indicated bulk forming laxatives should be the first line treatment and usually start to work after 2-3 days
- If stools remain hard, an osmotic laxative can be added or given instead
- If stools are soft but still difficult to pass add a stimulant to the bulk-forming laxative
- Osmotic laxatives usually start to work after 2-3 days, while stimulants act within 6-12 hours
- Most laxatives can cause bloating, flatulence, abdominal cramps, nausea and dehydration (look out for signs of light-headedness, headaches, darker urine)
A table containing further information about the different types of laxative is available to download in PDF format.Did you know? Bulk-forming or osmotic laxatives can cause dehydration if the patient is not well hydrated.
References1. How to get more fibre into your diet. NHS Eat well website. [Last reviewed 1 August 2018, cited 3 October 2018] Available from: https://www.nhs.uk/live-well/eat-well/how-to-get-more-fibre-into-your-diet/2. NICE Clinical Guideline 99. Constipation in children and young people: diagnosis and management. [Last reviewed July 2017, cited 3 October 2018] Available from: https://www.nice.org.uk/guidance/cg993. NICE Clinical Guideline 140. Palliative care for adults: strong opioids for pain relief. [Last reviewed August 2016, cited 3 October 2018] Available from: https://www.nice.org.uk/guidance/cg140
Understanding Continence Promotion: Effective Management of Bladder and Bowel Dysfunction in Adults
Our purpose is to transform access to education.
We offer a diverse selection of courses from leading universities and cultural institutions from around the world. These are delivered one step at a time, and are accessible on mobile, tablet and desktop, so you can fit learning around your life.
We believe learning should be an enjoyable, social experience, so our courses offer the opportunity to discuss what you’re learning with others as you go, helping you make fresh discoveries and form new ideas.
You can unlock new opportunities with unlimited access to hundreds of online short courses for a year by subscribing to our Unlimited package. Build your knowledge with top universities and organisations.