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What is your stepwise approach to treating constipation in a patient with symptoms such as abdominal pain, nausea, decreased appetite, etc?

What do you start initially, and how do you go about escalating the regimen if constipation persists?
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What is your preferred first-line class of laxatives to address constipation?

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2 Answers
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Mednet MemberInvited Expert
Hospital Medicine · University Of Wisconsin Health University Hospital
Answered on · Updated on

For patients that are symptomatic, I favor more aggressive management, often starting with polyethylene glycol (preferred) or another osmotic agent as first line. I will also usually supplement this with some sort of management from "below" but will usually discuss with the patient and nursing wheth...

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Mednet Member
Mednet MemberInvited Expert
Hospital Medicine · University of Nebraska
Answered on

With those symptoms, I find it best to be aggressive given what sounds like potential inability to tolerate enteral nutrition/meds. If that's the case, I would consider admission for a bowel clean out (using PEG and probably also something per rectum like an enema or suppository). Certainly I would ...

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