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Appropriate Use of Laxatives in the Older Person

  • Therapy in Practice
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Abstract

Constipation is a common condition, affecting up to half of all older adults during their lifetime. Untreated constipation has significant impacts, decreasing quality of life and potentially leading to urinary and/or faecal incontinence, faecal impaction and, in severe cases, hospitalisation. The increased constipation prevalence among older populations is multifactorial, with a number of age-related factors contributing to the rise in prevalence with aging. Laxatives are the mainstay of constipation management and are commonly used among older populations for both treatment and prevention of constipation. A range of laxative types including bulk forming agents, softeners and emollients, osmotic agents, stimulants, and the newer prokinetic and secretory agents are available. Despite laxatives being freely available without prescription in many countries and commonly used by older individuals, evidence regarding the effectiveness or safety of most laxatives in older populations is lacking. Additionally, age-related changes increase the risk of adverse effects associated with laxatives, such as electrolyte disturbances, among older persons. Caution must be taken when extrapolating recommendations for general adult populations to older populations. Laxative choice for older individuals should be tailored after careful assessment and consideration of comorbid conditions, concomitant medications and the potential for adverse effects.

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Authors and Affiliations

  1. Discipline of Pharmacy, Graduate School of Health, University of Technology Sydney (UTS), UTS Building 7, 67 Thomas Street, Ultimo, Sydney, NSW, 2006, Australia

    Lisa G. Pont & Kylie Williams

  2. The University of Sydney, Susan Wakil School of Nursing and Midwifery, University of Sydney, 88 Mallett St, Camperdown, NSW, 2050, Australia

    Lisa G. Pont & Murray Fisher

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  1. Lisa G. Pont
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  2. Murray Fisher
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Correspondence to Lisa G. Pont.

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No sources of funding were used in the preparation of this review.

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Lisa Pont, Murray Fisher and Kylie Williams declare no conflicts of interest relevant to the content of this review.

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Pont, L.G., Fisher, M. & Williams, K. Appropriate Use of Laxatives in the Older Person. Drugs Aging 36, 999–1005 (2019). https://doi.org/10.1007/s40266-019-00701-9

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