Constipation: common-sense care of the older patient

Constipation is a common complaint in older patients. Contributing factors are impaired general health, use of medications, and decreased mobility and physical activity. Diet has an indeterminate effect. Many patients become gradually more constipated with age and self-treat with over-the-counter laxatives. Investigation is warranted if defecation is associated with pain or bloating and/or represents a recent change in bowel habit. Although constipation is usually just an annoyance, it can have more serious consequences, such as impaction and ulceration. A combination of bowel training, dietary management, and regular exercise is the first phase of treatment. Bulk laxatives are second-line treatment, followed by other laxatives if needed.