Constipation Management

Symptoms:

1. Infrequent bowel movements
2. Hard, difficult-to-pass stools
3. Straining during defecation
4. Feeling of incomplete evacuation

Initial Management:

i. Impacted Stool: Phosphate enema.
ii. Hard Stool (not impacted): Stool softeners (e.g., docusate sodium).
iii. Constipation with Soft Stools: High-fiber diet and stimulant laxatives (e.g., senna).

Alternative Treatments:

iv. Osmotic Laxatives (e.g., lactulose, macrogol): Second-line treatment if stimulant laxatives are ineffective.
v. Glycerol Suppositories: Suitable for young, healthy patients with mild constipation.

Diagnosis and Management:

Diagnosis:
1. Based on clinical history and physical examination.
2. Consider additional investigations if there are alarming symptoms like blood in stool or significant weight loss.

Management:
. High-Fiber Diet: Increase dietary fiber to help soften stools and promote regular bowel movements.
. Stimulant Laxatives (e.g., senna): Used as the first-line pharmacological treatment for constipation with soft stools.
. Alternative Treatments: Stool softeners and osmotic laxatives if needed.
. Phosphate Enema: For cases with stool impaction.