ABSTRACT
This chapter focuses on a best practice approach to the management of constipation in palliative care, and provides an overview of constipation management in the context of caring for adults at the end of life. Constipation can be caused by a number of factors including decreased mobility, poor nutrition, medications, and bowel obstruction. In addition to clinical assessment of constipation as part of general history-taking and examination, specialised assessment tools have been developed. Although constipation is a common problem in patients receiving opioids, medical and nursing staff consistently underdiagnose the condition, in both outpatient and inpatient palliative-care settings. The usual preventive measures of increasing fluid intake, dietary fibre, and exercise require extra thought and care in persons receiving palliative care. Effective palliative care is essentially the provision of comfort, and includes a preventive approach to symptom management. Assessment should occur after each intervention to maintain symptom control and to assess side-effects of laxatives.
