Which statement best describes constipation management in this context?

• A. Increase fiber and fluids, exercise, lactulose or psyllium
• B. Decrease fiber and fluids
• C. Use stimulant laxatives only
• D. Avoid hydration

Answer: (A)

The main idea here is to start constipation management with nonpharmacologic measures that improve stool bulk and hydration. Increasing dietary fiber and fluids helps stools become softer, larger, and easier to pass, while regular exercise stimulates gut motility. When these steps aren’t enough, adding laxatives that work well with minimal stimulation—psyllium, a bulk-forming agent, and lactulose, an osmotic laxative—provides safe, effective relief by either increasing stool bulk or drawing water into the bowel. This approach specifically targets common contributors to constipation, such as low fiber intake, dehydration, and decreased motility, without risking the drawbacks of reducing fluids or relying on stimulant laxatives alone. Hydration should be maintained, not avoided. In this context, using fiber plus fluids and exercise, with bulk-forming or osmotic laxatives as needed, is the most appropriate first-line strategy.