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tweet guide to 𝗰𝗼𝗻𝘀𝘁𝗶𝗽𝗮𝘁𝗶𝗼𝗻For GPs & non-gastroenterology colleagues
Constipation is:
• Very common
• Under-recognised
• Often managed poorly
• Huge burden in 1° & 2° care
• Costs NHS millions
• Often a symptom of IBS
#GastroTwearls 1/4
Symptoms of 𝗰𝗼𝗻𝘀𝘁𝗶𝗽𝗮𝘁𝗶𝗼𝗻
• Classic constipation
• Abdo pain & bloating
If severe
• Diarrhoea (overflow)
• Urgency / incontinence
• Urinary retention
• Loss of appetite / nausea
• Rectal bleeding
• Confusion
#GastroTwearls 2/4
• Classic constipation
• Abdo pain & bloating
If severe
• Diarrhoea (overflow)
• Urgency / incontinence
• Urinary retention
• Loss of appetite / nausea
• Rectal bleeding
• Confusion
#GastroTwearls 2/4
Investigating 𝗰𝗼𝗻𝘀𝘁𝗶𝗽𝗮𝘁𝗶𝗼𝗻
A good history
• Loss of routine / WFH
•
exercise 
• Recent illness
•
women & elderly 
• Opioids, loperamide & other
• PMH constipation
• AXR useful
• 2WW if
(wt loss / 
)
#GastroTwearls 3/4
A good history
• Loss of routine / WFH
•
exercise • Recent illness
•
women & elderly • Opioids, loperamide & other
• PMH constipation
• AXR useful
• 2WW if
(wt loss / )#GastroTwearls 3/4
Management of 𝗰𝗼𝗻𝘀𝘁𝗶𝗽𝗮𝘁𝗶𝗼𝗻
• Clear explanation
• hydration & exercise
• Adjust diet
•
/ 
offending
• Prescribe laxido / movicol
• Avoid lactulose / bisacodyl in
• Raise
for better posture on
#GastroTwearls 4/4
• Clear explanation
•
hydration & exercise• Adjust diet
•
/ offending • Prescribe laxido / movicol
• Avoid lactulose / bisacodyl in
• Raise
for better posture on #GastroTwearls 4/4
