ASSIGNMENT

SUBMITTED TO: Dr. Saira Azhar

SUBMITTED BY: Muhammad Waqar
TOPIC: Case Study of Constipation
CLASS: M.Phil Pharmacy Practice
SESSION: 2022-2024

COLLEGE OF PHARMACY
UNIVERSITY OF SARGODHA

Scenario
Mr A is an 84-year-old man who is brought to your pharmacy by his wife to ask advice on his
constipation. On discussion with him you establish that he has recently been experiencing
back pain, which prevents him from getting about as much as he used to. The GP gave him
some co- dydramol 10 days ago, and things are starting to improve. His wife says that she
was given some little brown tablets when she was constipated, but they gave her stomach
pains. She tried to get him to take them, but he won’t. He thinks he should perhaps have
something gentle, like a herbal medicine.

1- How is constipation defined?

Ans:
Constipation is not solely defined by bowel frequency, but rather as a decrease in the patient's
normal pattern of defecation. Other criteria may also be considered for research purposes,
such as straining and hard stools.

2- Why do you think Mr A may have constipation?

Ans:
Factors that may contribute to Mr A's constipation include his age, decreased mobility due to
recent back pain, and his use of dihydrocodeine, which is known to cause constipation.

3- What symptoms would prompt you to suggest that Mr A should go to his GP?
Ans:
Blood in the stools, severe abdominal pain, unintentional weight loss, co-existing diarrhoea,
persistent symptoms, tenesemus or failure of previous medication. These symptoms can point
to more severe disorders such as impaction, or malignancy.

4- What sort of laxative do you think Mrs A has been taking? Explain your answer.
Ans:
From the description of the adverse effects, a stimulating laxative seems most likely, as they
commonly cause abdominal cramps. Senna is a stimulant laxative and is available as brown
tablets, and so this seems the most likely laxative.

5- What lifestyle changes would you recommend Mr A should take? What counselling
would you give him?
Ans:
Lifestyle measures such as increasing dietary fiber, ensuring adequate fluid intake, and
staying mobile may be recommended. A laxative may also be appropriate, and the benefits
and adverse effects of senna can be discussed with Mr A. He could start with one tablet
before bed and increase the dose if needed. Discuss his co-dydramol use and encourage him
to discuss his constipation with his GP.

6- How would you assess the success of this action?

Ans:
Ask Mr A to return if the laxative he has chosen has not worked, and ensure that the laxative
has been taken in the recommended dose and for an appropriate length of time

7- What would you suggest if your first recommendation fails?

Ans:
If the initial recommendation fails, ensure that Mr A has been taking the medication as
recommended and for a sufficient amount of time. If necessary, refer him to his GP.

Reference:
Chapter 1 Gastrointestinal case studies Pharmacy case study 2009.