Many drugs can slow down peristalsis. Antipsychotics, anticonvulsants, antidepressants, anticholinergics, hypertension medications, hypnotics, iron and calcium supplements can all cause constipation. Pain relief, including over the counter meds can cause or contribute towards constipation. Some muscle relaxants, by their nature can also impact and make the digestive processes less effective. Some medications for saliva control can have an influence on general hydration levels. The GP or medical professionals should always advise on any use of laxatives – as opposed to purchasing ‘over the counter’ remedies. Pharmacists are also a good source of help and advice! Assess the person’s toilet facilities, including functional ability to use the toilet, taking into account any postural difficulties. Moving your bowels is a private thing. Some people may find it more difficult if they are anxious or stressed or embarrassed. Tell me more… Squatting is the best position to open the bowels – see the attached diagrams of the most effective squatting position on the toilet. Some people may not be able to achieve this position. Ensure privacy, preserve dignity, encourage independence, and reduce any levels of stress or embarrassment the person may be experiencing. Consider any environmental aids and adaptions that can be made.
an ‘as required’ basis, assess its safe and effective administration. Tell me more… Laxative medication certainly has a part to play in the treatment of constipation. However it should be considered alongside all other lifestyle factors which may lead to a reduction in the need for medication. There is a risk that where ‘as required laxative medication is used very infrequently, monitoring of bowel movements may cease or become more informal. A faecal blockage can stay in a person’s bowel or colon for months or even years whilst the person appears to be using the toilet normally. This can lead to Sepsis which is a serious life threatening condition. and also be aware of any possible Is it also worth noting that the actions of laxatives may cause discomfort such as painful abdominal spasms, which can be confused with constipation itself. Where ‘as required’ laxative medication is prescribed, there should be clear guidance in the person’s support plan about when, how, and how long it should be used for. Where only ‘as required’ laxative medication is prescribed, and this is used infrequently, monitoring of the person’s bowel movements should continue to such a time that it is agreed by the person’s G.P., Learning
Assess the impact of effective communication between all concerned. Communication is the key to good and thorough assessment and to effective and consistent support. Sharing of important information, including the Bowel Management Plan, with all people who are involved in supporting the person, is crucial to them maintaining a healthy bowel. For some people, their emotional wellbeing can be directly affected by their bowel. Consider the effective use of communication passports or tools such as DisDAT, or use of symbols or other graphics and communication aids which may be helpful. Consider the effective passing of information between members of the support team. Is the recording chart completed on a daily basis? How is information about length of time between bowel movements or changes in the stool type shared amongst the team? Who is responsible for monitoring the completion of the recording chart?