An 88‑year‑old woman with severe osteoarthritis is admitted with constipation, abdominal pain and overflow diarrhoea. She takes co‑codamol 30/500 two

Question

An 88‑year‑old woman with severe osteoarthritis is admitted with constipation, abdominal pain and overflow diarrhoea. She takes co‑codamol 30/500 two tablets four times daily, amitriptyline and ferrous sulphate. Rectal examination reveals hard stool in the rectum; abdominal X‑ray shows faecal loading without obstruction. What is the most appropriate management?

Accepted Answer

Treat faecal impaction and reduce constipating medicines where possible

Answer

Arrange urgent colonoscopy before treating constipation

Answer

Give oral iron at a higher dose because anaemia causes constipation

Answer

Start loperamide to control overflow diarrhoea

Answer

Start solifenacin because overflow diarrhoea suggests urge incontinence

Faecal impaction with overflow diarrhoea — SCE Geriatric Medicine MCQ