Constipation assessment includes which elements?

• A. Only stool characteristics
• B. Symptoms such as anorexia and nausea only
• C. Labor and family history
• D. Characteristics and frequency of stool, use of bowel meds, fluid intake, anorexia, nausea, vomiting, concurrent medical conditions, problems prior to illness, abdominal assessment with palpation and DRE

Answer: (D)

Constipation assessment in palliative care is multi-dimensional and should capture both what the stool is like and what is influencing bowel function. The most complete assessment includes stool characteristics and frequency, use of bowel medications (laxatives, stool softeners, or any drugs that affect gut motility), fluid intake and overall hydration, associated symptoms such as anorexia, nausea, and vomiting, and relevant medical conditions that impact digestion or fluid balance. It also considers problems prior to the current illness and a focused physical examination, including abdominal assessment with palpation and, when appropriate, a digital rectal exam (DRE). This comprehensive approach identifies reversible factors (e.g., inadequate hydration, opioid-induced constipation, medication effects) and guides targeted management. Options focusing only on stool characteristics, or only on symptoms, or relying on labor and family history miss key contributing factors and therefore aren’t sufficient for a thorough assessment.