What lifestyle modifications should I advise to patients with constipation, and how effective are they?

Advise patients with constipation to manage their symptoms by giving advice on eating a healthy, balanced diet that includes whole grains, fruits high in sorbitol, and vegetables, with fibre intake gradually increased to about 30 g per day to minimize flatulence and bloating ¹.

Encourage adequate fluid intake, especially if there is a risk of dehydration, with at least 1.5 liters per day if appropriate, to support bowel function ¹.

Promote increased activity and exercise levels if these are below the recommended levels, as physical activity may help prevent constipation ¹.

Recommend helpful toileting routines, such as responding immediately to the sensation of needing to defecate, maintaining a regular, unhurried toilet routine, and ensuring access to privacy and support if mobility is limited ¹.

Advise on a regular, unhurried toilet routine, giving time to ensure complete defecation, and responding immediately to the sensation of needing to defecate ¹.

Ensure access to supported seating and appropriate help for those with limited mobility, and promote privacy during toileting ¹.

In cases where lifestyle measures are ineffective, consider a stepped approach with oral laxatives, starting with bulk-forming laxatives such as ispaghula ¹.