Prevention of constipation in palliative care

Help patients with palliative care needs avoid constipation by:

• encouraging them to use the toilet regularly at the same time each day and to take advantage of the gastrocolic reflex that occurs after eating
• ensuring adequate hydration
• optimising the amount of fibre in the patient’s diet if possible (eg drinking prune or pear juice)
• encouraging general activity by managing other symptoms (eg pain, breathlessness).

Prophylaxis is an essential part of managing constipation in patients with palliative care needs. Consider prescribing a laxative for all patients prescribed an opioid; see Laxatives used in palliative care for laxatives used in palliative care. Many other drugs can also cause constipation (see Examples of drugs that commonly cause constipation for examples) and prophylactic laxatives may need to be routinely prescribed. Patients with minimal oral intake may still require prophylaxis against constipation.