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Laxatives
Last updated 14th May 2021
Check recent PR examination findings or perform PR before laxative prescription.
- Ensure laxatives are prescribed PRN if patients are started on opioids
- Try a laxative from a single group, if not working add laxative from different group – eg Bisacodyl + Laxido/ Lactulose
- If faecally impacted – Arachis oil enema followed by phosphate enema can be tried. In cases of very hard faeces, manual evacuation may be necessary.
- Ensure stool charts are started and updated
- Types of laxatives
Group | Mechanism of action | Examples | Contraindications |
---|---|---|---|
Hyperosmotic | Intestines to hold more water within and create an osmotic effect that stimulates a bowel movement | Lactulose Glycerin supp Movicol, Laxido Phosphate enema | Intestinal perforation, bowel obstruction, ileus, IBD, and toxic megacolon |
Stimulants | Stimulate peristaltic actions | Bisacodyl | Intestinal obstruction, acute colitis |
Stool softeners | enable additional water and fats to be incorporated in the stool | Docusate | Acute abdomen, ileus |
Bulk forming agents | add bulk and water to stools | Dietary fibre Isphagula husk (Fybogel) | Obstruction |