Constipation bulk-forming agents

Treatment and prevention of constipation should consist of bulkforming agents in addition to dietary modifications that increase dietary fiber. A variety of products are available that provide adequate bulk. Whichever agent is chosen, it should be used daily and continued indefinitely in most patients, particularly those with chronic constipation. Bulk-forming agents available in combination with diphenyl-methane or anthraquinone derivatives should not be used on a routine basis. 

For patients taking bulk-forming agents, monitor for relief of constipation. Hard stools should become softer within 72 hours. 

The basis for treatment and prevention of constipation should consist of bulk-forming agents in addition to dietary modifications that increase dietary fiber. 

For some bedridden or geriatric patients, or others with chronic constipation, bulk-forming laxatives remain the first line of treatment, but the use of more potent laxatives may be required relatively frequently. Agents that may be used in these situations include milk of magnesia and lactulose. 

A 45-year-old woman comes into the clinic reporting constipation for the past 2 weeks. She recently started calcium carbonate supplementation per her doctor s advice for the prevention of osteoporosis. She would like to start one of the "natural" laxatives. Which of the following is a bulk-forming agent ... 

Constipation in most nonhospitalized patients can be resolved by increasing the fiber content of their diet or by supplementing the diet with bulk-forming agents. 

For some bedridden or geriatric patients, or others with chronic constipation, bnlk-forming laxatives remain the first line of treatment, but the use of more potent laxatives may be required relatively frequently. Fiber shonld be avoided in bedridden patients who are cognitively impaired. When other than bulk-forming laxatives are used, they should be administered in the lowest effective dose and as infreqnently as possible to maintain regular bowel function (more than three stools per week). Agents that may be used in these situations inclnde diphenylmethane and anthraquinone derivatives, milk of magnesia, and sorbitol or lacmlose. Mineral oil should be avoided. 

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