Constipation and diarrhoea

Constipation is a common problem for palliative care patients, notably due to opioid-based pain management which physiologically impacts gut motility. Idiopathic diarrhoea is far less common in palliative care patients given opioid management. If present, it should be investigated, although it is often related to suboptimal constipation treatment. The management and treatment of both symptoms is largely a balance between pharmacological and non-pharmacological interventions. New treatments for the management of constipation using peripherally acting mu-opioid antagonists (PAMORAs) offer effective solutions as part of a range of clinical interventions to prevent and manage the problem successfully. A clear descriptive history is essential for optimal treatment of both constipation and diarrhoea.