Q What’s the best way to manage constipation?
A Constipation is common, causing infrequent, hard stools, excessive straining, abdominal discomfort or bloating, but is generally self-manageable. The elderly may show confusion, functional decline, nausea and loss of appetite. Ensure a good fluid intake, a diet with veg and pulses, and take regular exercise. Then, if needed, start with bulk-forming laxatives containing fibre, such as psyllium or ispaghula husk, which increase the ‘bulk’ or weight of poo to stimulate your bowel. If stools remain hard, add or change to an osmotic laxative, such as macrogol or lactulose, that draws water from the rest of the body into your bowel, making it easier to pass. Other poo-softening laxatives, like docusate, may help. If the response is inadequate, a stimulant…
