Core IM | Internal Medicine Podcast #176 Constipation Medications: 5 Pearls Segment
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Apr 30, 2025 Discover the high-yield reversible causes of constipation and which type of fiber is truly beneficial. Dive into the debate on hydration and the effectiveness of bulk-forming laxatives versus osmotic and stimulant options. Learn about the intricacies of suppositories and enemas as treatment methods. Get insights on managing opioid-induced constipation with innovative alternatives like peripheral opioid receptor antagonists. This enlightening discussion equips you with practical recommendations for optimizing patient care!
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LMNOP Mnemonic for Causes
- The mnemonic LMNOP helps remember reversible constipation causes: lifestyle, metabolic, neurologic, obstructive, pharmacologic.
- Checking these can avoid unnecessary laxatives by identifying treatable factors.
Soluble Fiber First Line
- Advise patients to use soluble fiber like psyllium rather than insoluble fiber such as wheat bran.
- Recommend slow dose escalation to minimize bloating and take fiber separate from certain medications.
Hydration Guidance for Constipation
- Encourage hydration aiming for 1.5 to 2 liters per day to help alleviate constipation.
- Increasing fluid beyond adequate intake does not further improve constipation symptoms.