Constipation in the Elderly

Abstract

Constipation is a highly prevalent and bothersome disorder that negatively affects patients' social and professional lives and places a great economic burden on both patients and national health services. An accurate determination of the prevalence of constipation is difficult because of the various definitions used, but many epidemiological studies have shown that it affects up to 20% of the population at any one time. Although constipation is not a physiological consequence of normal aging, decreased mobility and other co-morbid medical conditions may contribute to its prevalence in older adults. Functional constipation is diagnosed when no secondary causes can be identified. Patients have some unusual beliefs about their bowel habits. Systematic attention to history, examination and investigation, especially in older people, can be highly effective in resolving problems and in enhancing quality of life. There is a considerable range of treatment modalities available for patients with constipation, but the clinical evidence supporting their use varies widely. However, if constipation is not managed proactively, patients can experience negative consequences, such as anorexia, nausea, bowel impaction or bowel perforation. The clinical benefits of various traditional pharmacological and non-pharmacological agents remain unclear. The first steps in the treatment of simple constipation include increasing intake of dietary fibre and the use of a fibre supplement. Patients with severe constipation or those unable to comply with the recommended intake of fibre may benefit from the addition of laxatives. More recently, newer agents (e.g. tegaserod and lubiprostone), have been approved for the treatment of patients with chronic constipation. Additional work is needed to determine what role, if any, these agents may play in the treatment of patients with chronic constipation. The purpose of this review is to identify evidence-based interventions for the prevention and management of constipation in the elderly.

Synergistic Effect of Fermented Rice Extracts on the Probiotic and Laxative Properties of Yoghurt in Rats with Loperamide‐Induced Constipation

“…Commonly used pharmacological agents for the treatment of constipation include bulk-forming laxatives (ispaghula husk, methylcellulose, and bran), stimulant laxatives (senna, bisacodyl, sodium picosulfate, and glycerin suppositories), osmotic laxatives (lactulose, magnesium sulphate, and phosphate enema), fecal softeners (docusate sodium, liquid paraffin, and arachis oil), and prokinetic agents (prucalopride and tegaserod) [1, 6]. However, laxatives also may induce side effects, such as severe diarrhea [7].…”

The effect of lifestyle modification on severity of constipation and quality of life of elders in nursing homes at Ismailia city, Egypt

“…In the elderly, with chronic constipation, history and physical examination to exclude medication-induced constipation and secondary causes are the first step. [78]…”

Traditional Chinese formula, lubricating gut pill, improves loperamide-induced rat constipation involved in enhance of Cl− secretion across distal colonic epithelium

“…Constipation is a highly prevalent and bothersome disorder that negatively affects patients' social and professional lives and places a great economic burden on both patients and national services (Spinzi et al, 2009). Many epidemiological studies have showed that it affects up to 20% of population, especially in the elderly, worldwide (Crowell et al, 2007;Pohl et al, 2008;Spinzi et al, 2009).…”

“…Many epidemiological studies have showed that it affects up to 20% of population, especially in the elderly, worldwide (Crowell et al, 2007;Pohl et al, 2008;Spinzi et al, 2009). Investigations have demonstrated that if people only have a bowel movement every 3-4 days, they are more at risk for having colonic cancer, hemorrhoids, irritable bowel syndrome (IBS), and many other illnesses (Shimotoyodome et al, 2000;Yang et al, 2008).…”

“…The initial steps in the treatment of relatively mild constipation include increasing intake of dietary fiber and using a fiber supplement. However, patients with severe constipation or those unable to comply with recommended intake of fiber should be treated with laxatives (Spinzi et al, 2009). Recently, two options were used to treat constipation.…”