Update on the management of constipation in the elderly: new treatment options

Satish SC Rao, Jorge T GoSection of Neurogastroenterology, Division of Gastroenterology-Hepatology, Department of Internal Medicine, Iowa City, University of Iowa Carver College of Medicine, Iowa City, IowaAbstract: Constipation disproportionately affects older adults, with a prevalences of 50% in c...

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Autores principales:	Satish SC Rao, Jorge T Go
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2010
Materias:	Elderly Constipation Treatment Geriatrics RC952-954.6
Acceso en línea:	https://doaj.org/article/ed1ae846b48e4183bb6481adb58162b9
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spelling	oai:doaj.org-article:ed1ae846b48e4183bb6481adb58162b92021-12-02T08:19:35ZUpdate on the management of constipation in the elderly: new treatment options1178-1998https://doaj.org/article/ed1ae846b48e4183bb6481adb58162b92010-06-01T00:00:00Zhttps://www.dovepress.com/update-on-the-management-of-constipation-in-the-elderly-new-treatment--peer-reviewed-article-CIAhttps://doaj.org/toc/1178-1998Satish SC Rao, Jorge T GoSection of Neurogastroenterology, Division of Gastroenterology-Hepatology, Department of Internal Medicine, Iowa City, University of Iowa Carver College of Medicine, Iowa City, IowaAbstract: Constipation disproportionately affects older adults, with a prevalences of 50% in community-dwelling elderly and 74% in nursing-home residents. Loss of mobility, medications, underlying diseases, impaired anorectal sensation, and ignoring calls to defecate are as important as dyssynergic defecation or irritable bowel syndrome in causing constipation. Detailed medical history on medications and co-morbid problems, and meticulous digital rectal examination may help identify causes of constipation. Likewise, blood tests and colonoscopy may identify organic causes such as colon cancer. Physiological tests such as colonic transit study with radio-opaque markers or wireless motility capsule, anorectal manometry, and balloon expulsion tests can identify disorders of colonic and anorectal function. However, in the elderly, there is usually more than one mechanism, requiring an individualized but multifactorial treatment approach. The management of constipation continues to evolve. Although osmotic laxatives such as polyethylene glycol remain mainstay, several new agents that target different mechanisms appear promising such as chloride-channel activator (lubiprostone), guanylate cyclase agonist (linaclotide), 5HT4 agonist (prucalopride), and peripherally acting μ-opioid receptor antagonists (alvimopan and methylnaltrexone) for opioid-induced constipation. Biofeedback therapy is efficacious for treating dyssynergic defecation and fecal impaction with soiling. However, data on efficacy and safety of drugs in elderly are limited and urgently needed.Keywords: constipation, elderly, treatmentSatish SC RaoJorge T GoDove Medical PressarticleElderlyConstipationTreatmentGeriatricsRC952-954.6ENClinical Interventions in Aging, Vol Volume 5, Pp 163-171 (2010)
institution	DOAJ
collection	DOAJ
language	EN
topic	Elderly Constipation Treatment Geriatrics RC952-954.6
spellingShingle	Elderly Constipation Treatment Geriatrics RC952-954.6 Satish SC Rao Jorge T Go Update on the management of constipation in the elderly: new treatment options
description	Satish SC Rao, Jorge T GoSection of Neurogastroenterology, Division of Gastroenterology-Hepatology, Department of Internal Medicine, Iowa City, University of Iowa Carver College of Medicine, Iowa City, IowaAbstract: Constipation disproportionately affects older adults, with a prevalences of 50% in community-dwelling elderly and 74% in nursing-home residents. Loss of mobility, medications, underlying diseases, impaired anorectal sensation, and ignoring calls to defecate are as important as dyssynergic defecation or irritable bowel syndrome in causing constipation. Detailed medical history on medications and co-morbid problems, and meticulous digital rectal examination may help identify causes of constipation. Likewise, blood tests and colonoscopy may identify organic causes such as colon cancer. Physiological tests such as colonic transit study with radio-opaque markers or wireless motility capsule, anorectal manometry, and balloon expulsion tests can identify disorders of colonic and anorectal function. However, in the elderly, there is usually more than one mechanism, requiring an individualized but multifactorial treatment approach. The management of constipation continues to evolve. Although osmotic laxatives such as polyethylene glycol remain mainstay, several new agents that target different mechanisms appear promising such as chloride-channel activator (lubiprostone), guanylate cyclase agonist (linaclotide), 5HT4 agonist (prucalopride), and peripherally acting μ-opioid receptor antagonists (alvimopan and methylnaltrexone) for opioid-induced constipation. Biofeedback therapy is efficacious for treating dyssynergic defecation and fecal impaction with soiling. However, data on efficacy and safety of drugs in elderly are limited and urgently needed.Keywords: constipation, elderly, treatment
format	article
author	Satish SC Rao Jorge T Go
author_facet	Satish SC Rao Jorge T Go
author_sort	Satish SC Rao
title	Update on the management of constipation in the elderly: new treatment options
title_short	Update on the management of constipation in the elderly: new treatment options
title_full	Update on the management of constipation in the elderly: new treatment options
title_fullStr	Update on the management of constipation in the elderly: new treatment options
title_full_unstemmed	Update on the management of constipation in the elderly: new treatment options
title_sort	update on the management of constipation in the elderly: new treatment options
publisher	Dove Medical Press
publishDate	2010
url	https://doaj.org/article/ed1ae846b48e4183bb6481adb58162b9
work_keys_str_mv	AT satishscrao updateonthemanagementofconstipationintheelderlynewtreatmentoptions AT jorgetgo updateonthemanagementofconstipationintheelderlynewtreatmentoptions
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Update on the management of constipation in the elderly: new treatment options

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