Q WHAT’S THE BEST WAY TO MANAGE CONSTIPATION?

AConstipation 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 plenty of regular exercise. Then if needed, start with bulk-forming laxatives, containing fibre, such as psyllium or ispaghula husk, which work by increasing 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, which 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 laxative, such as senna or bisacodyl, might help stimulate the muscles that line your gut to move poo along to your back passage. If you still have a problem, talk to your GP to exclude other causes, including medication you take, (such as codeine or diuretics), concurrent conditions, such as hypothyroidism, or other physical problems.