Management of chronic constipation in the elderly

Constipation is a common complaint among the elderly. Constipation can be defined as the passage of small hard stool infrequently and with difficulty. Definitions of constipation vary widely, and therefore Rome III criteria was recommended to be used in defining constipation. Constipation in the elderly is not simply related to the aging. It is a major feature of disorders of colorectal motility. The symptom of constipation could also arise secondary to other conditions. The management of chronic constipation in the elderly should include a detailed medical history and physical examination to exclude secondary causes for constipation. Laboratory evaluation should be performed in the initial assessment of the patient. If the initial investigations are normal, empiric therapy should be initiated. Patients not responding to the initial therapy are considered to have refractory constipation. Thus, diagnostic tests need to be performed in these patients. Further management such as newer medications, biofeedback and surgery might provide new hope to patients with refractory constipation. This review article focuses on the approach and treatment of chronic constipation in the elderly.