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Drugs & Aging

, Volume 25, Issue 10, pp 807–821 | Cite as

Management of Chronic Constipation in the Elderly

  • Paul F. Gallagher
  • Denis O’Mahony
  • Eamonn M. M. QuigleyEmail author
Review Article

Abstract

Constipation is a significant healthcare problem in the elderly. However, while undoubtedly common in the elderly, data on the prevalence of constipation in general and of its subtypes vary considerably, depending on the nature of the study population and their location. Furthermore, the complexity of the pathophysiology of constipation in this age group is little appreciated. Assumptions regarding ‘agerelated changes in colorectal physiology’ are, for the most part, not supported by scientific evidence and may serve to distract the clinician from uncovering the contributions of co-morbid diseases and the impact of iatrogenic factors. The evidence base from which one can develop recommendations on the management of constipation in the elderly is, for the most part, slim. This becomes most starkly apparent when one attempts to critically assess specific approaches to management. There is insufficient evidence to support the use of many commonly used laxatives both in the general population and in the elderly. Lifestyle interventions have value for some patients but data are lacking on the benefits of these interventions for patients with chronic constipation. Data in the elderly do not exist for most new pharmacological approaches to constipation. Pending the availability of good data, management of constipation in the elderly should be tailored to each individual’s needs and expectations, regardless of age or place of residence. In certain situations, constipation may be complicated by the development of impaction; preventive strategies are important in this context. We urge enrolment of many more elderly individuals with chronic constipation in clinical trials designed to address their particular needs.

Keywords

Constipation Irritable Bowel Syndrome Familial Mediterranean Fever Misoprostol Lactulose 
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.

Notes

Acknowledgements

No sources of funding were used to assist in the preparation of this review. The authors have no conflicts of interest that are directly relevant to the content of this review.

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© Adis Data Information BV 2008

Authors and Affiliations

  • Paul F. Gallagher
    • 1
  • Denis O’Mahony
    • 2
  • Eamonn M. M. Quigley
    • 2
    Email author
  1. 1.Department of Geriatric MedicineCork University HospitalCorkIreland
  2. 2.Alimentary Pharmabiotic Centre, Department of MedicineUniversity College CorkCorkIreland

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