The Management of Constipation

 In Pharmacy Information, Regulations and Standards

The MeReC Bulletin has produced an evidence based guideline on the treatment of constipation.

Drugs commonly prescribed in the mental health setting, with specific examples in brackets which may cause constipation include:

  • Antimuscarinics (procyclidine)
  • Antidepressants (tricyclics)
  • Antiepileptics (carbamazepine)
  • Antihistamines (promethazine)
  • Antipsychotics (clozapine)
  • Opoids (methadone, codeine)

In many cases, patients may be prescribed a combination of these drugs which will increase the risk and severity of constipation which could lead to obstruction or faecal impaction.

Regarding treatment, the smallest effective dose of laxative should be prescribed for the shortest period of time. If constipation is caused by a drug side-effect then prolonged laxative treatment may be required.

Changes in bowel habit may be a symptom of a serious underlying condition such as colorectal cancer, so medical referral may be required.

Further information: http://www.npc.nhs.uk/merec/therap/other/merec_bulletin_vol21_no2.php

 

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