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Constipation and diarrhoea 

Constipation and diarrhoea
Chapter:
Constipation and diarrhoea
Author(s):

Nigel P. Sykes

DOI:
10.1093/med/9780199656097.003.0203
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date: 07 May 2021

Constipation is far more common in palliative care than diarrhoea and results not just from the use of opioids but also from the multifactorial effects of debility secondary to disease. Most palliative care patients will require regular administration of an oral laxative in a dose titrated against response, with the aim of avoiding the use of suppositories or enemas if possible as these are less liked. The lack of clear differences in laxative efficacy means that cost and patient choice are key factors in guiding treatment. Diarrhoea in palliative care most often results from excess laxative or from common infections that can be simply managed. Bowel shortening or diversion causes more resistant diarrhoea. Cytotoxic chemotherapy can lead to diarrhoea either as an adverse effect of treatment or from potentially life-threatening neutropenic colitis.

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