Constipation and malignant bowel obstruction in palliative care

Constipation affects about half of patients with advanced illness and nearly all terminally ill patients receiving opioids. Constipation can be very distressing, leading to abdominal pain/distension, anorexia, nausea/vomiting, faecal impaction, intestinal obstruction, urinary retention and incontinence; reducing quality of life. A thorough assessment is critical to diagnose it, assess its severity, impact and associated symptoms, and find the cause. Management includes explanations to the patient/family, treating reversible causes (where appropriate) and optimizing non-pharmacological treatments and drugs.