Article Text

Assessment and management of constipation in terminal disease
  1. Rachael Nancekivell-Smith, Staff Nurse
  1. Inpatient Unit, St Christopher’s Hospice, London. Email: r.nksmith{at}


Constipation is a common symptom in advanced disease adversely affecting patients’ quality of life. Some palliative care patients rate the physical and psychological distress associated with constipation as worse than that associated with pain. The causes and treatment of constipation are often misunderstood. Constipation often results from the use of medication such as opioid analgesia, dietary factors, decreased mobility and other advanced disease-related factors. The best method of constipation management is prevention and identification of risk factors. This article provides an overview of the causes, assessment and management of constipation in patients with advanced disease. It then analyses critically the assessment and management of a patient with constipation who was admitted to a hospice. The patient’s anonymity has been protected by the use of a pseudonym, in accordance with Nursing and Midwifery Council (2008) guidelines. Verbal consent to report the case was obtained from the patient. Conflicts of interest: none

  • Assessment and management
  • Communication
  • Constipation
  • Palliative and end-of-life care

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