Constipation: a neglected condition in older emergency department patients

Area of Science:

• Geriatrics
• Emergency Medicine
• Gastroenterology

Background:

• Constipation and fecal impaction are prevalent issues in older adults, often leading to significant morbidity.
• Patients in the Emergency Department (ED) may present with classical or atypical symptoms of constipation.
• Atypical presentations can include paradoxical diarrhea, fecal incontinence, urinary retention, delirium, anorexia, and syncope.

Purpose of the Study:

• To review the prevalence, presentation, diagnosis, and management of constipation in older patients within the ED.
• To highlight the importance of considering atypical presentations and associated conditions.

Main Methods:

• This narrative review synthesizes existing literature on constipation in older ED patients.
• Focuses on diagnostic considerations and management strategies.

Main Results:

• Constipation presents with diverse symptoms in older ED patients, including classical and atypical signs.
• Underlying conditions (e.g., dementia, Parkinson's disease) and medications (e.g., opiates, anticholinergics) frequently contribute to constipation.
• Prompt recognition and management are essential to prevent complications.

Conclusions:

• Constipation is a significant concern in older ED populations, often presenting atypically.
• A comprehensive diagnostic approach considering comorbidities and medications is vital.
• Effective management strategies are necessary to reduce morbidity associated with constipation in this demographic.