Buku Medicine

Reversible causes

Quick Tip: Manage any reversible causes where possible, encourage fluids especially fruit juice and consider prescribing a laxative when starting medication that can cause constipation. 


Common reversible causes to consider 

  • Immobility / weakness  
  • Reduced food intake  
  • Fluid depletion – poor fluid intake, increased losses e.g. vomiting, fistulae  
  • Medication – including opioids, diuretics, anti-cholinergics, ondansetron, chemotherapy 
  • Intra-abdominal and pelvic disease 
  • Pain on defecation 
  • Biochemical – hypercalcaemia, hypokalaemia 
  • Environmental – lack of privacy, problems getting to a toilet 



NCA Handbook



Neurogenic constipation

In patients with spinal cord compression or sacral nerve damage who have lost sensation and/or control: 

  • Avoid oral stimulant laxatives which may cause uncontrolled bowel function 
  • Oral faecal softeners will prevent faeces becoming dry and hard 
  • Consider initiating a 3-day bowel regime (i.e. aim for a formed, not hard, stool and use stimulant suppositories to evacuate the bowel every 1-3 days) 


NCA handbook




Management flowchart

Laxative options