Treating constipation in seniors: A review of current treatments

January 28, 2013

For seniors who are constipated, the use of polyethylene glycol and lactulose are effective, according to a review of current treatments published in CMAJ (Canadian Medical Association Journal). The article reviews the latest evidence on the efficacy and safety of treatments to help doctors treat their patients.

Constipation, which increases with age, is a common complaint in seniors that can have serious health consequences and affect quality of life. Excessive straining in frail people can cause fainting and the risk of injury from falling or restrict blood flow to the heart and brain. Fecal impaction can cause nausea, loss of appetite and pain, which can lead to functional decline.

"Given the growing proportion of older adults in North America, effective management of constipation by will be increasingly necessary," writes Dr. Dov Gandell, Sunnybrook Health Sciences Centre, Toronto, with coauthors.

Constipation can be caused by medications such as opioids and iron pills as well as and diseases, although the main cause of the condition is not well understood.

Evidence from indicates that the use of osmotic agents such as and lactulose are effective in increasing the secretion of water in the colon, although these agents (especially lactulose) can cause bloating, gas and diarrhea. Soluble fibres such as psyllium are often used, although there is not strong evidence for effectiveness. Stimulant laxatives, such as senna and cascara which are naturally derived, have been shown to be effective but may become less effective with long-term use.

Increased fluid intake and exercise were not shown to alleviate constipation but should be undertaken for other health benefits.

The authors recommend a 9-step process to help patients manage constipation, which includes identifying symptoms and possible secondary causes, verifying or excluding impaction, optimizing behaviour, modifying diet and undergoing trials of various laxatives. Referral to a gastroenterologist or geriatrician would be the final step if the previous steps were unsuccessful.

"The symptoms [of constipation] can have a profound impact on quality of life and in certain circumstances may lead to ," state the authors. "Physicians should educate their patients on the wide range of normal bowel habits and the potential benefits of dietary modifications to improve symptoms."

Explore further: Fiber the best bet to help kids with constipation

More information: Research paper: www.cmaj.ca/lookup/doi/10.1503/cmaj.120819

Related Stories

Fiber the best bet to help kids with constipation

September 29, 2011
(Medical Xpress) -- Chronic constipation, or fewer than three bowel movements a week for two or more weeks, occurs in some 3% of children in Western countries and a new study published in Pediatrics shows that most common ...

Researchers find new treatment for constipation

May 10, 2011
Constipation is definitely not a glamorous topic. In reality, it affects nearly 30 million Americans and costs more than $1 billion annually to evaluate and treat. While not often life threatening, the pain, bloating, discomfort, ...

Chronic constipation linked to increased risk of colorectal cancer

October 22, 2012
Patients with chronic constipation may be at increased risk of developing colorectal cancer and benign neoplasms, according to study findings unveiled today at the American College of Gastroenterology's (ACG) 77th Annual ...

Recommended for you

Co-infection with two common gut pathogens worsens malnutrition in mice

July 27, 2017
Two gut pathogens commonly found in malnourished children combine to worsen malnutrition and impair growth in laboratory mice, according to new research published in PLOS Pathogens.

Finish your antibiotics course? Maybe not, experts say

July 27, 2017
British disease experts on Thursday suggested doing away with the "incorrect" advice to always finish a course of antibiotics, saying the approach was fuelling the spread of drug resistance.

Phase 3 trial confirms superiority of tocilizumab to steroids for giant cell arteritis

July 26, 2017
A phase 3 clinical trial has confirmed that regular treatment with tocilizumab, an inhibitor of interleukin-6, successfully reduced both symptoms of and the need for high-dose steroid treatment for giant cell arteritis, the ...

A large-scale 'germ trap' solution for hospitals

July 26, 2017
When an infectious airborne illness strikes, some hospitals use negative pressure rooms to isolate and treat patients. These rooms use ventilation controls to keep germ-filled air contained rather than letting it circulate ...

Researchers report new system to study chronic hepatitis B

July 25, 2017
Scientists from Princeton University's Department of Molecular Biology have successfully tested a cell-culture system that will allow researchers to perform laboratory-based studies of long-term hepatitis B virus (HBV) infections. ...

Male hepatitis B patients suffer worse liver ailments, regardless of lifestyle

July 25, 2017
Why men with hepatitis B remain more than twice as likely to develop severe liver disease than women remains a mystery, even after a study led by a recent Drexel University graduate took lifestyle choices and environments ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.