[Intestinal motility disorders in multimorbidity: between constipation and diarrhea]

Area of Science:

• Gastroenterology
• Geriatrics
• Internal Medicine

Background:

• Chronic constipation is a common complaint in the elderly, often presenting as a defecation disorder.
• The Rome IV criteria aid in distinguishing primary chronic constipation from other conditions.
• Identifying the underlying causes is crucial for appropriate management in older adults.

Purpose of the Study:

• To outline diagnostic strategies for chronic constipation in the elderly.
• To review current and emerging therapeutic possibilities for managing constipation in this demographic.

Main Methods:

• Utilizing the Rome IV criteria for diagnosis.
• Employing anamnesis, red flag observation, and geriatric basic assessment.
• Reviewing pharmacological interventions and lifestyle modifications.

Main Results:

• Distinguishing low-transit constipation from normal intestinal function significantly impacts therapeutic choices.
• Various pharmacological agents, including osmotic laxatives, stimulating laxatives, and opioid receptor antagonists, are available.
• Dietary interventions like fiber and prebiotics can be beneficial, though their efficacy may vary in severe cases.

Conclusions:

• Accurate diagnosis through comprehensive geriatric assessment is vital for effective constipation management in the elderly.
• A range of therapeutic options exists, from traditional laxatives to newer agents and lifestyle interventions.
• Individualized treatment plans considering the type and severity of constipation are essential.