Ms. RJ is a 70 year old woman who present for a follow-up. She complains of hard ,dry stools over the past weeks. She tried using fiber and increase her fluid intake with no positive results.
Past medical history: hypertension, chronic renal deficiency. Had a stroke one year ago with little or no residual
Medication used: Verapamil SR 240mg daily, lisinopril 10mg PO daily, Calcium carbonate1250mg P.O twice day, Aspirin325mg PO daily. She was diagnosed constipation
What laxative do you recommend for her? Explain your answer and what are the common side effect of it?
What would you suggest if your first recommend fails? Give second line and third line treatment. What is your advise toward her?
What lifestyle changes would you recommend MS.CJ should take ? What counselling would you give her? How would you assess the success of this action?