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Constipation assessment — DGM MCQ

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A 90-year-old woman has reduced appetite and new confusion. She takes opioids for vertebral fracture pain and has not opened her bowels for six days. Abdomen is distended and bowel sounds are present. Current medicines include morphine, senna and amlodipine. What is the most appropriate assessment?

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Correct answer: C — Assess for faecal impaction and bowel obstruction features

Severe constipation or faecal impaction can worsen appetite and delirium, and obstruction features should be assessed in an opioid-treated older person. Increasing opioid, treating dipstick alone, fluid restriction and memory referral miss the immediate bowel problem. Bowels are a core part of geriatric acute assessment.

Reference: NICE CKS constipation