What is the recommended initial approach for constipation in a patient with no allergies or other medical conditions?

• A. Advice on dietary and lifestyle measures
• B. Prescribe laxatives
• C. Refer to GP
• D. Start saline enemas

Answer: (A)

When constipation is uncomplicated and there are no other medical issues, the best starting approach is non-drug measures focused on diet and lifestyle. Increasing dietary fiber gradually (about 20–30 g per day from fruits, vegetables, whole grains, and possibly a bulk-forming supplement) helps produce softer, bulkier stools. Adequate fluids and regular physical activity support intestinal motility, and establishing a regular toilet routine reduces straining. These changes address the common functional causes of constipation, are safe, inexpensive, and empower the patient to manage symptoms without medications. If there’s no improvement after a brief trial of these measures (often 1–2 weeks) or if there are alarming features, then escalate to laxatives or further medical review. Starting laxatives immediately is not preferred because it bypasses modifiable lifestyle factors and can lead to dependence or side effects; referral to a GP is more appropriate when symptoms persist or red flags appear, and saline enemas are not first-line due to invasiveness and risk.