11. Case studies
Case study 1
Lucy is a 45-year-old sales executive. She has recently been constipated. She has suffered from
constipation occasionally in the past which she describes as ‘mild’. She has tried increasing the
amount of fibre in her diet and drinking plenty of fluids but so far, this has not improved her
symptoms sufficiently. She is not taking any other medication and on questioning, she has no ‘red flag’ symptoms.
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Consider the questions you would need to ask Lucy and what treatment you would recommend.
Case study 1 - Answer
Lucy has just come back from a week-long holiday and it was during this trip abroad that she
became constipated. You have established that her symptoms are mild so you can reassure her
that it is not uncommon for people to become constipated when they are away from home in
unfamiliar surroundings. Lucy has already considered her diet (which should be encouraged)
but as this has not provided relief from the symptoms, you should let her know that this is not
always the solution. As Lucy is not displaying any ‘red flag’ symptoms it is appropriate to treat
her in the pharmacy without the need for GP referral.
Lucy could be recommended a stimulant laxative treatment which can give her predictable
overnight relief. As she has not taken a laxative treatment previously, you could consider Dulcolax
Perles®, containing sodium picosulfate, which has a flexible dosing option allowing Lucy to start
on a minimum dosage of two perles and increasing to up to four if required12.
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