Drugs & Aging

, Volume 6, Issue 6, pp 465–469 | Cite as

Epidemiology of Constipation in Elderly Patients

Drug Utilisation and Cost-Containment Strategies
  • Frank A. Lederle
Review Article Epidemiology


Constipation is a common complaint among elderly people, resulting in large amounts of money being spent on laxatives. Strategies for improving patient care while reducing this expenditure include: (a) counselling patients that daily bowel movements and purging are not essential to good health, (b) greater use of non-pharmacological measures such as hydration, exercise and dietary fibre, and (c) considering safety, effectiveness and cost in the selection of a laxative. Generic preparations of psyllium and sorbitol can be recommended in this regard. The widespread use of stool softeners, magnesium hydroxide (‘milk of magnesia’) and stimulant laxatives is difficult to justify from the available data.


Constipation Misoprostol Lactulose Chronic Constipation Magnesium Hydroxide 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Johanson JF, Sonnenberg A, Koch TR. Clinical epidemiology of chronic constipation. J Clin Gastroenterol 1989; 11: 525–36PubMedCrossRefGoogle Scholar
  2. 2.
    Harari D, Gurwitz JH, Minaker KL. Constipation in the elderly. J Am Geriatr Soc 1993; 41: 1130–40PubMedGoogle Scholar
  3. 3.
    Heaton KW, Cripps HA. Straining at stool and laxative taking in an English population. Dig Dis Sci 1993; 38: 1004–8PubMedCrossRefGoogle Scholar
  4. 4.
    Wesselius-De Casparis S, Braadbaart S, van der Bergh-Bohlken GE, et al. Treatment of chronic constipation with lactulose syrup: results of a double-blind study. Gut 1968; 984–6Google Scholar
  5. 5.
    Andorsky RI, Goldner F. Colonic lavage solution (polyethylene glycol electrolyte lavage solution) as a treatment for chronic constipation: a double-blind, placebo-controlled study. Am J Gastroenterol 1990; 85(3): 261–65PubMedGoogle Scholar
  6. 6.
    Connor WE. Dietary fiber — nostrum or critical nutrient? N Engl J Med 1990; 322: 193–5PubMedCrossRefGoogle Scholar
  7. 7.
    Muller-Lissner SA. Effect of wheat bran on weight of stool and gastrointestinal transit time: a meta analysis. BMJ 1988; 296: 615–7PubMedCrossRefGoogle Scholar
  8. 8.
    Egger G, Wolfenden K, Pares J, et al. Bread: it’s a great way to go. Med J Aust 1991; 155: 820–1PubMedGoogle Scholar
  9. 9.
    Hull C, Greco RS, Brooks DL. Alleviation of constipation in the elderly by dietary fiber supplementation. J Am Geriatr Soc 1980; 28: 410–4PubMedGoogle Scholar
  10. 10.
    Tedesco FJ, DiPiro JT. Laxative use in constipation. Am J Gastroenterol 1985; 80: 303–9PubMedGoogle Scholar
  11. 11.
    Hyland CM, Foran JD. Dioctyl sodium sulphosuccinate as a laxative in the elderly. J Chron Dis 1968; 200: 698–9Google Scholar
  12. 12.
    Goodman J, Pang J, Bessman AN. Dioctyl sodium sulphosuccinate: an ineffective prophylactic laxative. J Chron Dis 1976; 29: 59–63PubMedCrossRefGoogle Scholar
  13. 13.
    Fain AM, Susat R, Herring M, et al. Treatment of constipation in geriatric and chronically ill patients: a comparison. South Med J 1978; 71: 677–80PubMedCrossRefGoogle Scholar
  14. 14.
    Chapman RW, Sillery J, Fontana DD, et al. Effect of oral dioctyl sodium sulphosuccinate on intake: output studies of human small and large intestine. Gastroenterol 1985; 89: 489–93Google Scholar
  15. 15.
    Castle SC, Cantrell M, Israel DS, et al. Constipation prevention: empiric use of stool softeners questioned. Geriatrics 1991; 46(11): 84–6PubMedGoogle Scholar
  16. 16.
    Muller-Lissner SA. Adverse effects of laxatives: fact and fiction. Pharmacology 1993; 47 Suppl. 1: 138–45PubMedCrossRefGoogle Scholar
  17. 17.
    Kinnunen O, Salokannel J. The carry-over effect on the bowel habit in elderly long-term patients of long-term bulk-forming products containing stimulant laxative. Acta Med Scand 1987; 222: 477–9PubMedCrossRefGoogle Scholar
  18. 18.
    Sanders JF. Lactulose syrup assessed in a double-blind study of elderly constipated patients. J Am Geriatr Assoc 1978; 26: 236–9Google Scholar
  19. 19.
    Bass P, Dennis S. The laxative effect of lactulose in normal and constipated subjects. J Clin Gastroenterol 1981; 3 Suppl. 1: 23–8PubMedCrossRefGoogle Scholar
  20. 20.
    Rouse M, Chapman N, Mahapatra M, et al. An open, randomised, parallel group study of lactulose versus ispaghula in the treatment of chronic constipation in adults. Br J Clin Pract 1991; 45: 28–30PubMedGoogle Scholar
  21. 21.
    Connolly P, Hughes IW, Ryan G. Comparison of ‘Duphalac’ and ‘irritant’ laxatives during and after treatment of chronic constipation: a preliminary study. Curr Med Res Opin 1975; 2: 620–5CrossRefGoogle Scholar
  22. 22.
    Kinnunen O, Winblad I, Koistinen P, et al. Safety and efficacy of a bulk laxative containing senna versus lactulose in the treatment of chronic constipation in geriatric patients. Pharmacology 1993: 47 Suppl. 1: 253–5PubMedCrossRefGoogle Scholar
  23. 23.
    Passmore AP, Wilson-Davies K, Stoker C, et al. Chronic constipation in long stay elderly patients: a comparison of lactulose and a senna-fibre combination. BMJ 1993; 307: 769–71PubMedCrossRefGoogle Scholar
  24. 24.
    Lederle FA, Busch DL, Bendickson KM, et al. Cost-effective treatment of constipation in the elderly: a randomized double-blind comparison of sorbitol and lactulose. Am J Med 1990; 89: 597–601PubMedCrossRefGoogle Scholar
  25. 25.
    Muller-Lissner SA, Bavarian Constipation Study Group. Treatment of chronic constipation with cisapride and placebo. Gut 1987; 28: 1033–8PubMedCrossRefGoogle Scholar
  26. 26.
    Soffer EE, Metcalf A, Launspach J. Misoprostol is effective treatment for patients with severe chronic constipation. Dig Dis Sci 1994; 39: 929–33PubMedCrossRefGoogle Scholar
  27. 27.
    Passmore AP. Economic aspects of pharmacotherapy for chronic constipation. PharmacoEconomics 1995; 7: 14–24PubMedCrossRefGoogle Scholar

Copyright information

© Adis International Limited 1995

Authors and Affiliations

  • Frank A. Lederle
    • 1
  1. 1.Department of Medicine (III-0), One Veterans Drive, Minneapolis Veterans Affairs Medical CenterUniversity of MinnesotaMinneapolisUSA

Personalised recommendations