Calls to action

Individual practical recommendations have been developed in consultation with the European expert working group, to support better management of chronic constipation in older adults across the whole multi-disciplinary team.

Select one of the headings below to view the relevant recommendations:

General practitioners (GPs)
  • Support development of guidelines to support prevention, diagnosis and management of constipation in older adults and those living in care homes
  • Support development of a universal definition of constipation, to be used across all disciplines
  • Routine use of Bristol Stool Form Scale and rectal examination
  • Review patient medication to avoid poly-pharmacy
  • Ensure prompt treatment uptake to avoid complications caused by untreated constipation
  • Monitor diet, hydration and mobility in older adults to ensure preventative measures are in place
  • Develop and disseminate training materials to colleagues/peers
  • Adopt trigger questioning techniques to achieve accurate diagnoses of patients and encourage self-reporting
  • Develop/seek multi-disciplinary education and training materials to support best practice constipation management and share with colleagues/peers
  • Employ appropriate and timely referral of patients to incontinence care providers, where they exist.
Gastroenterologists and gerontologists
  • Support development of guidelines to support prevention, diagnosis and management of constipation in older adults and those living in care homes
  • Support development of a universal definition of constipation, to be used across all disciplines
  • Routine use of the Bristol Stool Form Scale and rectal examination
  • Ensure prompt treatment uptake to avoid complications caused by untreated constipation
  • Evaluate existing constipation assessment tools, for example Bristol Stool Form Scale and ensure uptake, where appropriate
  • Develop/seek multi-disciplinary education and training materials to support best practice constipation management and share with colleagues/peers
  • Employ appropriate and timely referral of patients to incontinence care providers, where they exist.
Neurologists
  • In patients with neurological conditions, such as dementia and Alzheimer’s disease, ensure prompt treatment following a diagnosis.
Nurses
  • Support development of guidelines to support prevention, diagnosis and management of constipation in older adults and those living in care homes
  • Support development of a universal definition of constipation, to be used across all disciplines
  • Routine use of the Bristol Stool Form Scale and rectal examination
  • Ensure prompt treatment uptake to avoid complications caused by untreated constipation
  • Monitor diet, hydration and mobility in older adults to ensure preventative measures in place
  • Develop/seek multi-disciplinary education and training materials to support best practice constipation management and share with colleagues/peers
  • Employ appropriate and timely referral of patients to incontinence care providers, where they exist.
Pharmacists
  • Support development of guidelines to support prevention, diagnosis and management of constipation in older adults and those living in care homes
  • Support development of a universal definition of constipation, to be used across all disciplines
  • Review patient medication to avoid poly-pharmacy
  • Ensure prompt treatment uptake to avoid complications caused by untreated constipation
  • Monitor diet, hydration and mobility in older adults to ensure preventative measures in place
  • Develop/seek multi-disciplinary education and training materials to support best practice constipation management and share with colleagues/peers
  • Employ appropriate and timely referral of patients to incontinence care providers, where they exist.
Care home staff
  • Routine use of the Bristol Stool Form Scale and rectal examination
  • Encourage proactive case finding and suspect and assess constipation in all older adults in care homes
  • Follow step-by-step treatment guidance, if available, to ensure patients are adhering to their treatment regimen
  • Adopt questioning techniques to achieve accurate diagnoses of patients and encourage self-reporting
  • Provide adequate toileting support for care home residents, particularly those with communication difficulties
  • Employ appropriate and timely referral of patients to incontinence care providers, where they exist.
Commissioners and policy makers
  • Evaluate available economic data to highlight financial burden of constipation in terms of hospitalisations, complications, loss of independence and need for social care
  • Consider constipation as an indicator of best practice care quality measures within existing frameworks
  • Manage optimal care provision for patients, where services exist on a local level.
Patient organisations
  • Encourage greater open discussion about constipation as a common health issue through campaigning and information provision
  • Develop information resources for patients/carers
  • Support better self-reporting through questioning techniques.