Evaluating and Managing Constipation in the Elderly

David A. Ginsberg, MD; Sidney F. Phillips, MD; Joyce Wallace, MSN, CRNP, APRN-BC; Karen L. Josephson, MD

Disclosures

Urol Nurs. 2007;27(3):191-200, 212. 

In This Article

Abstract and Introduction

Abstract

Constipation is common in the elderly because of age-related physiologic changes and polypharmacy. Secondary constipation is treated by correcting underlying pathology or reducing predisposing factors. Primary constipation is amenable to dietary adjustments, education and behavioral training, and laxatives when necessary.

Introduction

Constipation encompasses many defecatory disorders and means different things to health care providers and patients. Causes of constipation include colon disease, metabolic disturbances, neurologic disorders, pharmacotherapy, and inappropriate diet and fluid intake. The multiplicity of causes explains why constipation is common and why many patients may not respond to initial treatment. Constipation can be mild to severe and acute or chronic. Its impact varies, but constipation tends to be most troublesome and costly in the elderly. Older people often have a number of diseases or take medications that can exacerbate constipation and make it difficult to treat; this can lead to potentially serious medical complications. However, regardless of age, constipation adversely affects health-related quality of life (HRQL) (Glia & Lindberg, 1997).

Although constipation is not a urologic disorder, many elderly patients with such disorders take medications that increase the risk of constipation. They may also voluntarily restrict fluid intake in hopes of decreasing urologic symptoms, an approach that may increase the risk of constipation and worsen urologic symptoms because of anatomic obstruction from constipated stool in the lower colon or rectum. Thus, an understanding of the causes of constipation and its treatment is valuable in managing older patients with urologic disorders.

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