Constipation with soft faeces in the rectum in palliative care
For information on general management of constipation and laxatives used in palliative care, see Management of constipation in palliative care.
If rectal examination determines constipation is due to soft faeces in the rectum, initially use a stimulant suppository to promote rectal emptying. For example, use:
bisacodyl 10 mg suppository rectally, as a single dose. bisacodyl
Enemas can be ineffective because they may not be retained in the rectum for long enough to have an effect.
Follow initial therapy with an oral regimen; for example, use:
bisacodyl 5 mg orally, at night, increasing up to 10 mg twice daily bisacodyl
PLUS EITHER
1docusate+senna 50+8 mg 1 or 2 tablets orally, once daily at night or twice daily docusate + senna
OR
If the above therapy is ineffective, seek specialist advice.
After constipation resolves, review the patient’s regular laxative regimen and modify if necessary, or consider starting a regular regimen to prevent recurrence.