ABSTRACT
Patients who, like Mark, score more than 4 on the Norgine risk assessment tool
should have further assessment and appropriate actions taken (see Box 9.11).
The main groups of laxatives are bulking agents (e.g. Isogel, regulan), stimulants
(e.g. senna, bisocodyl), stool softeners and lubricants (liquid paraffin, ducoset sodium)
and osmotic agents (e.g. lactulose); see the British National Formulary for more
details (www.bnf.org). Although laxatives may be necessary to prevent and manage
constipation, they are preferably a short-term measure only. The RCN (2006a)
identified that, for people with learning disabilities, there has been an over-reliance on
laxatives rather than promoting adequate nutrition and fluid intake. Where feasible,
medicines that predispose to constipation should be avoided particularly in those
who are at risk. Exercise should be increased if possible.
