Constipation prevention

Drugs that are known to cause constipation should be avoided, or given with laxatives, in any patient who is encephalopathic or could become so, e.g. in acute liver failure and cirrhosis. Constipation prevents the clearance of toxic waste products in the bowel that can accumulate, cross the blood-brain barrier and cause (or worsen) encephalopathy. Examples of drugs to use with caution/avoid are ... 

Fiber supplements vary in the types of fiber that they contain. Psyllium, a naturally occurring soluble fiber, has been studied extensively, and research suggests a benefit in terms of constipation prevention, cholesterol reduction, blood sugar control, and weight loss, particularly when combined with a healthy diet. It also seems to help those suffering from irritable bowel syndrome (IBS), a common condition associated with bowel irregularity, bloating, and abdominal pain. 

Prior to this work, dietary fiber, of which ceUulose is oae of the more important constituents, was considered important primarily as a means of preventing or overcoming constipation. Otherwise, dietary fiber was considered to be a metaboHcally iaert substance. A large variety of diseases such as appendicitis, hiatus hernia, gallstones, ischemic heart disease, diabetes, obesity, dental caries, and duodenal ulcers are now suspected to be associated with the consumption of a highly refined diet (42). 

MANAGING CONSTIPATION. Constipation caused by decreased gastric motility can be a problem widi cholinergic dm. The nurse urges the patient to increase fluid intake up to 2000 mL daily (if healdi conditions permit), eat a diet high in fiber, and obtain adequate exercise The primary healdi care provider may prescribe a stool softener, if necessary, to prevent constipation. 

OILE ACID SEQUESTRANTS. Fhtients taking the antihyperlipidemic dragp, particularly the bile acid sequestrants, may experience constipation. The dragp can produce or severely worsen preexisting constipation. The nurse instructs the patient to increase fluid intake, eat foods high in dietary fiber, and exercise daily to help prevent constipation. If the problem persists or becomes... 

A laxative is most often prescribed for the short-term relief or prevention of constipation. Certain stimulant, emollient, and saline laxatives are used to evacuate the colon for rectal and bowel examinations. Fecal softeners or mineral oil are used prophylactically in patients who should not strain during defecation, such as after anorectal surgery or a myocardial infarction. Psyllium may be used in patients with irritable bowel syndrome and diverticular disease. Fblycarbophil may be prescribed for constipation or diarrhea associated with irritable bowel syndrome and diverticulosis. Mineral oil is... 

Constipation may occur as an adverse drug reaction. When the patient has constipation as an adverse reaction to another drug, the primary care provider may prescribe a stool softener or another laxative to prevent constipation during the drug therapy. Display 48-2 lists the names of some dm and drug classifications that may cause constipation. 

LAXATIVES. The nurse records file results of administration on the patient s chart. If excessive bowel movements or severe prolonged diarrhea occur or if file laxative is ineffective, the nurse notifies file primary health care provider. If a laxative is ordered for constipation, the nurse encourages a liberal fluid intake and an increase in foods high in fiber to prevent a repeat of this problem. 

Vinorelbine 30 mg/m2 IV infused over 15 minutes on days 1 and 8 repeat every 21 days 29% Constipation, neutropenia, anemia, thrombocytopenia, neurotoxicity 1. Consider bowel regimen to prevent constipation. 

Elderberry is not only nourishing, it also promotes a healthy metabolism. It helps break up mucus congestion, helps prevent free radicals from damaging healthy cells, treats constipation by loosening old fecal matter lodged in the colon and helps to stimulate natural peristaltic movement. Elder also helps eliminate water and fat that is unnecessarily stored in the body. 

A major goal for treatment of constipation is prevention of constipation by alteration of lifestyle (particularly diet) to prevent further episodes of constipation. For acute constipation, the goal is to relieve symptoms and restore normal bowel function. 

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

Emollient laxatives are not effective in treating constipation but are used mainly to prevent constipation. They may be helpful in situations where straining at stool should be avoided, such as after recovery from myocardial infarction, with acute perianal disease, or after rectal surgery. 

It is unlikely that these agents are effective in preventing constipation if major causative factors (e.g., heavy opiate use, uncorrected pathology, inadequate dietary fiber) are not concurrently addressed. 

When using opioids, prevent constipation with a Gl stirmJant. 

The best management of opioid-induced constipation is prevention. Patients should be counseled on proper intake of fluids and fiber, and a laxative should be added with chronic opioid use. 

Therefore, dietetic and pharmacological measures should be taken prophylacti-cally to prevent constipation, whenever prolonged administration of opioid drugs is indicated. 

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