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Constipation

The sphincter muscles themselves are not weakened by MND. Incontinence is therefore not a common problem. Constipation is, however, a frequent problem and can be caused by immobility, modified diet, poor fluid intake, medications - especially analgesics and anticholinergic drugs, and inability to strain due to weak abdominal, diaphragmatic and glottic muscles (MND Australia 2014).

MND Australia 2014

Management

  • optimise fluid intake if possible
  • faecal softeners if stool is hard e.g Coloxyl tablets or lactulose syrup
  • bowel stimulants if bowel transit still slow e.g Senna, Durolax
  • If the patient is able to swallow easily or gastrostomy feeding is available - Movicol
  • regular rectal evacuant to overcome weak muscles of defecation e.g suppositories
  • microlax enemas, usually given three times per week
  • Note: Diarrhoea may be due to constipation with overflow.

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