Issues for surgery
Risk of constipation if omitted, particularly in patients with chronic laxative use, which may further be exacerbated by medication administered perioperatively, e.g. opioids.
Advice in the perioperative period
Elective surgery
Continue, if required.
EXCEPT:
- for patients having bowel cleansing preparations prior to surgery – stop when bowel preparation starts.
Emergency surgery
Continue, if required.
EXCEPT:
- for patients with suspected bowel obstruction or perforation.
Post-operative advice
Resume post-operatively, if needed.
If concomitant use of opioids or other medication that may cause constipation, or antibiotics that may cause diarrhoea, monitor response to treatment and adjust dose accordingly.
Patients undergoing colorectal surgery
Review the need for stimulant laxatives post-operatively.
Use of suppositories following certain types of colorectal surgery are not recommended; confirmation should be sought from the colorectal team before prescribing if stimulant laxatives are required post-operatively.
Interactions with common anaesthetic agents
None.
Interactions with other common medicines used in the perioperative period
None.
Further information
None relevant.
References
Baxter K, Preston CL (eds), Stockley’s Drug Interactions (online) London: Pharmaceutical Press. http://www.medicinescomplete.com [Accessed 23 March 2024]
Glycerin Suppositories BP 4g Adult Size. Thornton & Ross Ltd. Accessed via www.medicines.org.uk 23/03/24 [date of revision of the text January 2015]
Joint Formulary Committee. British National Formulary (online) London: BMJ Group and Pharmaceutical Press http://www.medicinescomplete.com [Accessed on 23 March 2024]