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- For many clients bulk-forming drugs should be the first choice, as these mimic the natural action of food on the intestine and can be used over a longer period of time.
- For a client in whom straining is potentially harmful or painful, faecal softeners are the agents of choice.
- A short course of a stimulant laxative may be of use if clients do not respond to bulk-forming drugs or appear to have more advanced constipation.
- Severe constipation and faecal impaction may only respond initially to the use of suppositories or enemas.
- Oral laxatives are contraindicated when impaction is present but may be prescribed when the faecal mass has been removed.
- A bulk-forming agent daily or another laxative once or twice weekly may be necessary if the client fails to respond to dietary and other non-pharmacological measures.
Prescribing in children
Few paediatricians appear to be in favour
of laxatives and enemas for children and regular dosing is discouraged unless specifically
prescribed by a physician. The nurse prescriber should consult with a physician before
prescribing a laxative for a child.
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