Bowels should still be opened regularly by all patients on tube feeds, although it may be different than before and different for each patient. Problems with constipation should be tackled promptly and not left to get worse.

The following should be considered:

  • Frequency and Medical History: Did the patient open bowels regularly before starting on enteral feeding? Is there any relevant medical history, especially any pre-existing bowel disorders?
  • Activity: If the patient is mobile, encouraging as much activity as possible will help reduce constipation. The type of activity will vary depending upon the age and ability of the patient.
  • Fluids: Extra water can help - aim to increase water intake by 100 - 200mls per day initially in an adult.  In hot weather a tube fed patient may need a lot more water - both adults and children. Discuss with the dietitian if additional fluid is needed.
  • Dietary Fibre: Consider more routine use of fibre containing feeds. The dietitian might consider trying a fibre supplement along with the feed, for example Resource Optifibre or HyFiber.  Discuss with the community dietitian.
  • If any food is taken orally, then foods that help constipation should be encouraged.  These include fruits, vegetables, wholegrain breads and cereals, nuts, and seeds, especially linseeds. Please ensure that any recommendations made by Speech and Language regarding texture and/or consistency are followed.
  • Gut Motility: Changes in gut motility may require the use of Laxatives or enemas to ease issues with constipation.
  • Medication: There is a wide variety of medications that can cause constipation or make it worse.  It may be possible to swap medicines if this is a real issue. Consult a specialist doctor, GP or pharmacist for advice.

Examples of medicines that can cause constipation include:

  • Opioid pain relievers e.g. Codeine, Morphine
  • Antispasmodics e.g. dicyclomine
  • Anti-cholinergic agents e.g. Atropine, Trihexiphenidyl
  • Calcium channel blockers used in arrhythmias and high blood pressure e.g. verapamil
  • Some Parkinson's drugs e.g. levodopa
  • Some antipsychotics e.g. clozapine
  • Iron supplements
  • Anticonvulsants e.g. conazepan, phenytoin.

If the patients' condition allows, try to have a good Toilet Routine:

  • Encouraging going for a poo at a regular time and place and allowing sufficient time
  • Not delaying if there is the urge to poo
  • Checking position when trying to poo - resting feet on a low stool and if possible raising the knees above the hips.

If you would like this information in another format, for example large print or easy read, or if you need help communicating with us, please contact:

First Community (Head Office)

Call: 01737 775450 Email:    fchc.enquiries@nhs.net    Text: 07814 639034

Address: First Community Health and Care, Consort House, 5-7 Queensway, Redhill, Surrey, RH1 1YB.

For office use only: Version 4 GU_TS003 Publication date: May 2026