Pilot Study of the Effect of Lactulose on Post Caesarean Section Constipation
Pilot Study of the Effect of Lactulose on Post Caesarean Section Constipation
Constipation following elective Caesarean sections (CS) is a common problem experienced by up
 to 50% of patients (1). The causes for this are multifactorial and include manipulation of
 the bowel during surgery, immobilisation and opiate based anaesthetic and analgesic
 techniques. To try to alleviate the problem of postoperative constipation, some anaesthetists
 prescribe postoperative lactulose in addition to postoperative analgesia, although no data
 exists that shows whether this has any beneficial effect on postoperative constipation.

 1. Short term morbidity associated with Caesarean delivery. Hillan EM. Birth. 19 (4): 190-4).
Inclusion Criteria:

 -  All patients aged 16 years or older able to give informed consent undergoing their
 first or second elective CS

 Exclusion Criteria:

 -  Unable to give informed consent

 -  A basic level of literacy sufficient to complete postoperative form.

 -  History of constipation

 -  Regular opiate use

 -  Previous bowel surgery or bowel adhesions

 -  Lactose intolerant

 -  Diabetic

 -  Any patient unable to have spinal Anaesthesia

 -  Allergies/intolerant to bupivacaine, diamorphine, diclofenac, cocodamol, lactulose

 -  Patients receiving injury to bowel intraoperatively

 -  Patients receiving additional opiates perioperatively