Constipation in the elderly

Area of Science:

• Geriatrics
• Gastroenterology
• Internal Medicine

Background:

• Constipation affects a significant percentage of elderly men and women, diminishing quality of life.
• It can indicate serious underlying conditions like mass lesions or systemic disorders (e.g., hypothyroidism).
• Medications, such as narcotic analgesics, are common culprits for constipation.

Purpose of the Study:

• To outline the evaluation and management of constipation in the elderly population.
• To emphasize identifying and treating the root cause of constipation.

Main Methods:

• Patient history focusing on fluid/food intake, medications, supplements, and homeopathic remedies.
• Physical examination to identify contributing factors like local masses or thrombosed hemorrhoids.
• Consideration of colon visualization when the cause is not apparent.

Main Results:

• Constipation can be multifactorial, stemming from lifestyle, systemic issues, or medications.
• Identifying the specific cause is crucial for effective treatment.
• Chronic laxative use should be discouraged.

Conclusions:

• First-line management includes bowel retraining, increased dietary fiber, adequate fluid intake, and exercise.
• Laxatives, stool softeners, and nonabsorbable solutions may be necessary adjuncts for chronic cases.
• Treatment must be individualized to the underlying cause of constipation.