-- Robert Preidt
MONDAY, Jan. 28 (HealthDay News) -- Some treatments are more
effective than others for relieving constipation in seniors,
according to a new review.
And laxatives aren't always enough, researchers say.
Constipation is common in seniors and can have serious health
consequences and affect quality of life. Excessive straining in
frail elderly people can cause them to faint and put them at risk
of injury or falling, or restrict blood flow to the heart and
Chronic constipation can lead to fecal impaction, a large lump
of hard stool that remains stuck in the rectum. Fecal impaction can
cause nausea, pain and loss of appetite.
"Given the growing proportion of older adults in North America, effective management of constipation by health care professionals will be increasingly necessary," Dr. Dov Gandell, of Sunnybrook Health Sciences Centre in Toronto, and colleagues wrote in an article appearing Jan. 28 in the CMAJ (Canadian Medical Association Journal).
The authors reviewed the latest evidence on the effectiveness
and safety of treatments for constipation in seniors and found that
osmotic agents such as polyethylene glycol and lactulose are
effective in increasing the secretion of water in the colon. These
agents (especially lactulose), however, can cause gas, bloating and
diarrhea, according to a journal news release.
Soluble fibers, such as psyllium are often used to treat
constipation, but the researchers found strong evidence for their
effectiveness. Naturally derived stimulant laxatives such as senna
and cascara have been shown to be helpful but may become less
effective with long-term use.
Although increased fluid intake and exercise were not shown to
be effective ways to relieve constipation, they do provide other
health benefits and are recommended for seniors, according to the
They outlined a nine-step process to help doctors manage seniors
with constipation. It includes: identifying symptoms and possible
secondary causes; confirming or ruling out fecal impaction;
improving lifestyle behaviors; modifying diet; and trying various
If these and other initial steps are unsuccessful, patients
should be referred to a gastroenterologist or geriatrician, the
"Physicians should educate their patients on the wide range of normal bowel habits and the potential benefits of dietary modifications to improve symptoms," they concluded.
The U.S. National Institute on Aging has more about
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